| Procedure Code | Procedure Description | Pricing Indicator | Rate Type | Mod1 | Mod2 | Mod3 | Mod4 | Max Fee | Max Fee Eff. Date | Max Fee End Date | PA |
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | NRB | NA | NA | NA | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | OLB | NA | NA | NA | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | NLB | NA | NA | NA | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | MAXFEE | ORU | 10.62 | 11/1/2021 | 12/31/2299 | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | ARB | NA | NA | NA | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | MAXFEE | OLU | 8.84 | 11/1/2021 | 12/31/2299 | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | ALB | NA | NA | NA | Y N | ||||
| T1000 | PRIVATE DUTY/INDEPENDENT NSG | HHPDN | ORB | NA | NA | NA | Y N | ||||
| T1001 | NURSING ASSESSMENT/EVALUATN | MAXFEE | ORU | 10.53 | 11/1/2021 | 12/31/2299 | N | ||||
| T1001 | NURSING ASSESSMENT/EVALUATN | MAXFEE | NRC | 7.38 | 11/1/2021 | 12/31/2299 | N | ||||
| T1001 | NURSING ASSESSMENT/EVALUATN | MAXFEE | ARC | 8.83 | 11/1/2021 | 12/31/2299 | N | ||||
| T1001 | NURSING ASSESSMENT/EVALUATN | MAXFLT | NRA | NA | NA | NA | N | ||||
| T1001 | NURSING ASSESSMENT/EVALUATN | MAXFLT | ARA | NA | NA | NA | N |