New York State seal

NEW YORK INSURANCE NOTICES AND BULLETINS

March 4, 1980

SUBJECT: INSURANCE

WITHDRAWN

Circular LETTER NO. 4 (1980)

March 4, 1980

TO: ALL INSURERS LICENSED TO WRITE AUTOMOBILE INSURANCE IN NEW YORK STATE

SUBJECT: REIMBURSEMENT RATES FOR HOSPITAL AND HEALTH RELATED SERVICES UNDER NO-FAULT

Pursuant to the provisions of 11 NYCRR 68.2 (Regulation 83), on and after January 1, 1978, the schedule of all inclusive rates for hospital services and health related services, including home health services, provided pursuant to Section 671(1)(a) of the Insurance Law shall be the rates approved by the Chairman of the Workers' Compensation Board in accordance with the provisions of Chapter 767 of the Laws of 1977.

Pursuant to the provisions of Regulation 83 and effective with services rendered on and after January 1, 1980, through December 31, 1980, the attached schedules shall be utilized by no-fault insurers for payment of hospital outpatient and inpatient services. The rates appearing in the attached schedules have been developed in accordance with Chapter 767 of the Laws of 1977 as amended by Chapter 213 of the Laws of 1978 and Chapter 271 of the Laws of 1979 (extending the provisions of Chapter 767 for an additional year) and have been approved by the Chairman of the Workers' Compensation Board.

Also attached is a schedule of revised rates certified by the Commissioner of Health and approved by the Chairman of the Workers' Compensation Board relating to specified facilities. Pursuant to the provisions of Regulation 83 these revised rates shall be utilized by no-fault insurers for payment of hospital inpatient services for the effective periods set forth in the schedule.

Very truly yours,

[SIGNATURE]

ALBERT B. LEWIS

Superintendent of Insurance

This schedule of revised rates was recommended and certified by the State Commissioner of Health and approved by the Chairman of the Workers' Compensation Board. Pursuant to Chapter 767, Laws of 1977, as amended by Chapter 213, Laws of 1978 and Chapter 271, Laws of 1979, these rates are for use in payment of claims under the Workers' Compensation Law and Volunteer Firemen's Benefit Law.

These rates apply to the following facilities for the periods indicated:

NEW YORK CITY REGION - REVISED RATES

INPATIENT

FROM

TO

EFFECTIVE PERIOD

Hosp. for Joint Diseases

$ 241.00

$ 339.00

1/1/79 - 1/31/79

 ("Old" Facility)

241.00

341.00

2/1/79 - 7/9/79

Orthopedica Institute

0

524.00

7/10/79 - 10/31/79

0

534.00

11/1/79 - 12/31/79

North General Hospital

0

240.00

7/10/79 - 12/31/79

[SIGNATURE]

Chairman

DISTRIBUTION: BS

STATE OF NEW YORK

WORKERS' COMPENSATION BOARD

OFFICE OF THE CHAIRMAN

HOSPITAL FEE SCHEDULE

Effective January 1, 1980

This schedule was recommended and certified by the State Commissioner of Health and approved by the Chairman of the Workers' Compensation Board. Pursuant to Chapter 767, Laws of 1977, as amended by Chapter 213, Laws of 1978 and Chapter 271, Laws of 1979, these rates are for use in payment of claims under the Workers' Compensation Law and the Volunteer Firemen's Benefit Law.

[SIGNATURE]

Chairman

WORKERS' COMPENSATION SCHEDULE OF RATES FOR THE PERIOD JANUARY 1, 1980 THROUGH DECEMBER 31, 1980

Rates for Outpatient Services

Room other than operating room or operating room when used for minor surgery or emergency treatment:

For the medical service provided whether by employed staff,

$ 13.00

attending staff or by contractual arrangement with the

physician groups the fee for this service is limited to

the first visit fee of as appears on line 90010 of the

Schedule of Medical Fees.

For the hospital providing intern or resident staffing

$ 36.00

or by physician group contractual coverage the total

fee is

When the care is provided by an attending, the hospital fee

$ 23.00

is with the physician billing separately.

Note: These fees include common or ordinary medications.

Crutches, mechanical splints and appliances

Rental or

Sale at Cost

Plaster Cast and/or Splint

Cost of Plaster

Radium and deep therapy

A & A *

E.K.G., E.E.G., X-ray, P.T., and Laboratory Charges

Rates in

Schedule of

Medical Fees

Promulgated

by the Chairman,

Workers'

Compensation

Board

Materials supplied by the Emergency Room (i.e.

sterile trays, medications, etc.) over and above

those usually included with the Emergency Room visit

may be charged for separately. Itemize these on

the bill submitted.

* "Authorization and Arrangement"

COMMON OR ORDINARY DRUGS COVERED BY THE EMERGENCY ROOM HOSPITAL RATES

A study was undertaken some time ago to determine the low-cost drugs which a large number of hospitals in New York State regard as fairly common or ordinary and for which no charges are made apart from the inclusive Emergency Room rates. A partial list of such drugs is furnished below. It is expected that the list will be enlarged or augmented from time to time. In the meanwhile, the drugs shown below or on any future similar list or heretofore regarded as common or ordinary or any additional drugs so regarded at the discretion of the hospital should be considered as covered by the applicable Emergency Room rate. No charge should be made for [A> ANY <A] drugs, whether or not listed hereunder, in connection with hospitalized patients.

Current List of "No Charge" Drugs and Pharmaceutical Supplies

Alcohol 70%

Alcohol for burning

Alkaline Aromatic (Seilers) Tablets (Used as a mouth wash)

Aluminum Hydroxide Gel.

Ammonium Chloride Tabs.

A. P. C.

Aromatic Sp. Ammonia

Aromatic Fl. Ext. Cascara

Aspirin

Atropine Sulphate H.T.'s

Belladonna Tincture

Benedicts Qualitative Solution

Benzalkonium Chloride

Benzoin Tincture

Calamine Lotion

Carbon Tetrachloride

Castor Oil

Chloral Hydrate

Citrocarbonate Granules

Clinitest Tablets

Codeine Sulphate H.T.

Cold Cream Ointment

Collodian Flexible

Comp. Licorice Powd.

Comp. Tr. Benzoin

Demoral

Dicumarol Tabs.

Digitoxin Tabs. O.1. mg.

Distilled Water Inject.

Ferric Chloride Solution

Ferric Subsulphate (Mansels) Solution

Ferrous Sulphate

Glycerin

Glycerin Supp.

H. I. Syrup

Hydrogen Peroxide

Iodine

Iron Quinine & Strychnine Elixir

Laxative Tabs.

Liquid Soap

Lubricating Jelly

Magnesium Sulphate

Metaphen Tincture

Methiolate Sol.

Methyl Salicylate

Milk of Magnesia

Mineral Oil

Morphine Injection

Mouth Wash

Nitroglycerine H.T.'s

Normal Saline Inject.

Pento Barbital Sodium Capsules

Peppermint

Petralatum

Phenobarbital

Procaine HCL

Rhubarb & Soda Mixture

Rubbing Alcohol

Scopolamine H.T.

Secobarbital Sodium Caps

Silver Nitrate Appl.

Sodium Bicarbonate

Sodium Salicylate Tabs.

Talcum Powder

Terpin Hydrate El.

Tuberculin Purified Protein Derivative (1st and 2nd strength)

Witch Hazel

Xylocaine 1%, 2% with or without Epinephrine

Zinc Oxide Ointment

Zinc Stearate Powder

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

WESTERN NEW YORK REGION

EFFECTIVE

DAILY

01/01/80 -

12/31/80

RATE

EXCLUSIONS:

ALLEGANY

 CUBA MEMORIAL HOSPITAL INC

$ 183.00

ALL INCLUSIVE

   INPATIENT ACUTE CARE

 MEMORIAL HOSPITAL OF WM F & GERTRUDE F JONES

 A/K/A JONES MEMORIAL

   INPATIENT ACUTE CARE

$ 164.00

ALL INCLUSIVE

CATTARAUGUS

 OLEAN GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 163.00

ALL INCLUSIVE

 SALAMANCA HOSPITAL DISTRICT AUTHORITY

   INPATIENT ACUTE CARE

$ 129.00

B,C

 ST FRANCIS HOSPITAL

   INPATIENT ACUTE CARE

$ 157.00

B

 TRI-COUNTY MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 133.00

B

CHAUTAUQUA

 BROOKS MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 134.00

A,B

 JAMESTOWN GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 147.00

A,B,C

 LAKE SHORE HOSPITAL INC

   INPATIENT ACUTE CARE

$ 143.00

A,B

 WESTFIELD MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 114.00

B,C

 WOMANS CHRISTIAN ASSOCIATION

   INPATIENT ACUTE CARE

$ 155.00

A,B

ERIE

 BERTRAND CHAFFEE HOSPITAL

   INPATIENT ACUTE CARE

$ 161.00

A

 BRY-LIN HOSPITAL

   PSYCHIATRIC CARE

$ 135.00

A

 BUFFALO COLUMBUS HOSPITAL

   INPATIENT ACUTE CARE

$ 108.00

A,C,D

 BUFFALO GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 198.00

ALL INCLUSIVE

 CHILDRENS HOSPITAL

   INPATIENT ACUTE CARE

$ 281.00

A

 ERIE COUNTY MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 281.00

ALL INCLUSIVE

 KENMORE MERCY HOSPITAL

   INPATIENT ACUTE CARE

$ 158.00

A, OTHER: EKG

 LAFAYETTE GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 128.00

A

 MERCY HOSPITAL

   INPATIENT ACUTE CARE

$ 153.00

A

 MILLARD FILLMORE HOSPITAL

   INPATIENT ACUTE CARE

$ 202.00

A

 OUR LADY OF VICTORY HOSPITAL OF LACKAWANNA

   INPATIENT ACUTE CARE

$ 154.00

A,B

ERIE

 ROSWELL PARK MEMORIAL INSTITUTE

   INPATIENT ACUTE CARE

$ 251.00

ALL INCLUSIVE

 SAINT FRANCIS HOSPITAL OF BUFFALO

   INPATIENT ACUTE CARE

$ 139.00

A

 SHEEHAN MEMORIAL EMERGENCY HOSPITAL INC

   INPATIENT ACUTE CARE

$ 158.00

A,B

 SHERIDAN PARK HOSPITAL INC

   INPATIENT ACUTE CARE

$ 141.00

A

 SISTERS OF CHARITY HOSPITAL

   INPATIENT ACUTE CARE

$ 154.00

A

 ST JOSEPH INTERCOMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 128.00

A

GENESEE

 GENESEE MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 155.00

A

 ST JEROME HOSPITAL

   INPATIENT ACUTE CARE

$ 164.00

A

NIAGARA

 DEGRAFF MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 149.00

A

 INTER-COMMUNITY MEMORIAL HOSPITAL AT

 NEWFANE INC

   INPATIENT ACUTE CARE

$ 140.00

A

 LOCKPORT MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 155.00

A,B

 MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS

   INPATIENT ACUTE CARE

$ 144.00

A

 NIAGARA FALLS MEMORIAL MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 160.00

A

ORLEANS

 ARNOLD GREGORY MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 156.00

A,C

 MEDINA MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 145.00

A,B

WYOMING

 WYOMING COUNTY COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 169.00

A

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

ROCHESTER NEW YORK REGION

EFFECTIVE

DAILY

01/01/80 - 12/31/80

RATE

EXCLUSIONS:

CHEMUNG

 ARNOT-OGDEN MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 178.00

A

 ST JOSEPHS HOSPITAL

   INPATIENT ACUTE CARE

$ 149.00

A

LIVINGSTON

 NICHOLAS H NOYES MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 172.00

A

MONROE

 GENESEE HOSPITAL

   INPATIENT ACUTE CARE

$ 266.00

A

 HIGHLAND HOSPITAL

   INPATIENT ACUTE CARE

$ 223.00

A,B

 LAKESIDE MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 176.00

A

 MONROE COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 292.00

ALL INCLUSIVE

 PARK RIDGE HOSPITAL

   INPATIENT ACUTE CARE

$ 208.00

A,B

 ROCHESTER GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 262.00

A

 ST MARYS HOSPITAL

   INPATIENT ACUTE CARE

$ 210.00

A,C

 STRONG MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 300.00

A, Other-Diagnostic Radio

ONTARIO

 CLIFTON SPRINGS HOSPITAL AND CLINIC

   INPATIENT ACUTE CARE

$ 162.00

A

 F F THOMPSON HOSPITAL

   INPATIENT ACUTE CARE

$ 143.00

A

 GENEVA GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 187.00

A

SCHUYLER

 SCHUYLER HOSPITAL

   INPATIENT ACUTE CARE

$ 178.00

A

SENECA

 SENECA FALLS HOSPITAL

   INPATIENT ACUTE CARE

$ 171.00

ALL INCLUSIVE

 WATERLOO MEMORIAL HOSPITAL INC D/B/A

 TAYLOR-BROWN MEMORIAL HOSP

   INPATIENT ACUTE CARE

$ 149.00

A

STEUBEN

 BETHESDA HOSPITAL

   INPATIENT ACUTE CARE

$ 153.00

A

 CORNING HOSPITAL

   INPATIENT ACUTE CARE

$ 164.00

A

 IRA DAVENPORT MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 151.00

A, C

 ST JAMES MERCY HOSPITAL

   INPATIENT ACUTE CARE

$ 143.00

A

WAYNE

 MYERS COMMUNITY HOSPITAL FOUNDATION INC

   INPATIENT ACUTE CARE

$ 153.00

A

 NEWARK-WAYNE COMMUNITY HOSPITAL INC

   INPATIENT ACUTE CARE

$ 168.00

A

YATES

 SOLDIERS AND SAILORS MEMORIAL HOSPITAL

 OF YATES COUNTY INC

   INPATIENT ACUTE CARE

$ 165.00

A

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

CENTRAL NEW YORK REGION

EFFECTIVE

DAILY

01/01/80 - 12/31/80

RATE

EXCLUSIONS:

BROOME

 BINGHAMTON GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 178.00

A,B,C

 CHARLES S WILSON MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 209.00

A

 IDEAL HOSPITAL OF ENDICOTT

   INPATIENT ACUTE CARE

$ 131.00

A,B,C

 OUR LADY OF LOURDES MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 175.00

A, OTHER: DIAGNOSTIC

RADIOLOGY, ULTRASOUND

DIAGNOSTIC

CAYUGA

 AUBURN MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 160.00

A

CHENANGO

 CHENANGO MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 209.00

A

CORTLAND

 CORTLAND MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 202.00

A,B

HERKIMER

 HERKIMER MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 170.00

A

 LITTLE FALLS HOSPITAL

   INPATIENT ACUTE CARE

$ 144.00

A

 MOHAWK VALLEY GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 148.00

A

JEFFERSON

 CARTHAGE AREA HOSPITAL INC

   INPATIENT ACUTE CARE

$ 158.00

A,B

 EDWARD JOHN NOBLE

 HOSPITAL OF ALEXANDRIA BAY

   INPATIENT ACUTE CARE

$ 173.00

ALL INCLUSIVE

 HOUSE OF THE GOOD SAMARITAN

   INPATIENT ACUTE CARE

$ 167.00

A,B,C

 MERCY HOSPITAL OF WATERTOWN

   INPATIENT ACUTE CARE

$ 176.00

A,B,C

LEWIS

 LEWIS COUNTY GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 160.00

B

MADISON

 COMMUNITY MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 185.00

A

 ONEIDA CITY HOSPITAL

   INPATIENT ACUTE CARE

$ 154.00

A,D

ONEIDA

 CHILDRENS HOSPITAL AND

 REHABILITATION CENTER

   REHABILITATION

$ 177.00

A,C, OTHER: EMG

ONEIDA

 FAXTON HOSPITAL

   INPATIENT ACUTE CARE

$ 173.00

A,C, OTHER; EMG

 ROME HOSPITAL AND MURPHY MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 154.00

A,C

 ROSE HOSPITAL

   INPATIENT ACUTE CARE

$ 144.00

A

 ST ELIZABETH HOSPITAL

   INPATIENT ACUTE CARE

$ 187.00

A

 ST LUKES MEMORIAL HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 188.00

A,C

ONONDAGA

 BENJAMIN RUSH CENTER

   PSYCHIATRIC CARE

$ 119.00

ALL INCLUSIVE

 COMMUNITY-GENERAL HOSPITAL OF GREATER

 SYRACUSE

   INPATIENT ACUTE CARE

$ 230.00

A

 CROUSE-IRVING MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 271.00

A,B,D, OTHERS: Nuclear

Medicine, EEG, ECG

 ST JOSEPHS HOSPITAL HEALTH CENTER

   INPATIENT ACUTE CARE

$ 226.00

A,B,C

 STATE UNIVERSITY HOSPITAL UPSTATE

 MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 247.00

A,C

OSWEGO

 ALBERT LINDLEY LEE MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 159.00

A

 OSWEGO HOSPITAL

   INPATIENT ACUTE CARE

$ 168.00

A

ST. LAWRENCE

 A BARTON HEPBURN HOSPITAL

   INPATIENT ACUTE CARE

$ 197.00

A

 CENTRAL ST LAWRENCE HLTH SERVICES OF

 POTSDAM HOSP UNIT

   INPATIENT ACUTE CARE

$ 180.00

A

 CLIFTON-FINE HOSPITAL

   INPATIENT ACUTE CARE

$ 183.00

ALL INCLUSIVE

 EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR

   INPATIENT ACUTE CARE

$ 128.00

ALL INCLUSIVE

 MASSENA MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 170.00

A

TIOGA

 TIOGA GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 163.00

A,C

TOMPKINS

 TOMPKINS COUNTY HOSPITAL

   INPATIENT ACUTE CARE

$ 216.00

A

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

NORTHEASTERN NEW YORK REGION

EFFECTIVE

DAILY

01/01/80 - 12/31/80

RATE

EXCLUSIONS:

ALBANY

 ALBANY MEDICAL CENTER HOSPITAL

   INPATIENT ACUTE CARE

$ 207.00

B

 CHILDS HOSPITAL

   INPATIENT ACUTE CARE

$ 160.00

A

 COHOES MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 150.00

A,B

 MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 195.00

A

 ST PETERS HOSPITAL

   INPATIENT ACUTE CARE

$ 202.00

A,B

CLINTON

 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL

 MEDICAL CTR

   INPATIENT ACUTE CARE

$ 138.00

A,B

COLUMBIA

 COLUMBIA MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 168.00

B

DELAWARE

 A LINDSAY & OLIVE B OCONNOR HOSPITAL

   INPATIENT ACUTE CARE

$ 169.00

A

 COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 177.00

ALL INCLUSIVE

 DELAWARE VALLEY HOSPITAL INC

   INPATIENT ACUTE CARE

$ 201.00

ALL INCLUSIVE

 MARGARETVILLE MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 195.00

ALL INCLUSIVE

 READ MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 170.00

A,B

 THE HOSPITAL

   INPATIENT ACUTE CARE

$ 160.00

A,B, OTHER: Ultrasound,

Electro-Cardiology

ESSEX

 ELIZABETHTOWN COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 163.00

B

 MOSES-LUDINGTON HOSPITAL

   INPATIENT ACUTE CARE

$ 159.00

A,B,C,D

 PLACID MEMORIAL HOSPITAL INC

   INPATIENT ACUTE CARE

$ 158.00

A

FRANKLIN

 ALICE HYDE MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 143.00

B

 GENERAL HOSPITAL OF SARANAC LAKE

   INPATIENT ACUTE CARE

$ 155.00

A,B,C

 MERCY GENERAL HOSPITAL OF TUPPER LAKE

   INPATIENT ACUTE CARE

$ 164.00

A

FULTON

 JOHNSTOWN HOSPITAL

   INPATIENT ACUTE CARE

$ 162.00

A,C

 NATHAN LITTAUER HOSPITAL

   INPATIENT ACUTE CARE

$ 155.00

A

GREENE

 MEMORIAL HOSPITAL OF GREENE COUNTY

   INPATIENT ACUTE CARE

$ 177.00

ALL INCLUSIVE

MONTGOMERY

 AMSTERDAM MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 157.00

A

 ST MARYS HOSPITAL AT AMSTERDAM

   INPATIENT ACUTE CARE

$ 153.00

A,C

OTSEGO

 AURELIA OSBORN FOX MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 193.00

A,C, OTHER: Ear,Nose,Throa

 MARY IMOGENE BASSETT HOSPITAL

   INPATIENT ACUTE CARE

$ 185.00

ALL INCLUSIVE

RENSSELAER

 LEONARD HOSPITAL

   INPATIENT ACUTE CARE

$ 166.00

B,C

 SAMARITAN HOSPITAL

   INPATIENT ACUTE CARE

$ 169.00

A

 ST MARYS HOSPITAL OF TROY

   INPATIENT ACUTE CARE

$ 168.00

A,B, OTHER: Physical

Medicine

SARATOGA

 ADIRONDACK REGIONAL HOSPITAL

   INPATIENT ACUTE CARE

$ 136.00

ALL INCLUSIVE

 BENEDICT MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 71.00

A,C

 SARATOGA HOSPITAL

   INPATIENT ACUTE CARE

$ 169.00

A,B

SCHENECTADY

 BELLEVUE MATERNITY HOSPITAL INC

   INPATIENT ACUTE CARE

$ 268.00

A

 ELLIS HOSPITAL

   INPATIENT ACUTE CARE

$ 183.00

A,B,C, OTHER; Nuclear

Medicine

 ST CLARES HOSPITAL

   INPATIENT ACUTE CARE

$ 180.00

A,B

 SUNNYVIEW HOSPITAL AND REHABILITATION

 CENTER

   INPATIENT ACUTE CARE

$ 160.00

A,C

SCHOHARIE

 COMMUNITY HOSPITAL OF SCHOHARIE

 COUNTY INC

   INPATIENT ACUTE CARE

$ 149.00

ALL INCLUSIVE

WARREN

 GLENS FALLS HOSPITAL

   INPATIENT ACUTE CARE

$ 173.00

A,B,C

WASHINGTON

 EMMA LAING STEVENS HOSPITAL

   INPATIENT ACUTE CARE

$ 145.00

ALL INCLUSIVE

 MARY MCCLELLAN HOSPITAL

   INPATIENT ACUTE CARE

$ 154.00

A

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

NORTHERN METROPOLITAN REGION

EFFECTIVE

DAILY

01/01/80 - 12/31/80

RATE

EXCLUSIONS:

DUTCHESS

 HIGHLAND HOSPITAL

   INPATIENT ACUTE CARE

$ 153.00

A

 NORTHERN DUTCHESS HOSPITAL

   INPATIENT ACUTE CARE

$ 166.00

A

 ST FRANCIS HOSPITAL

   INPATIENT ACUTE CARE

$ 202.00

A,B,C, OTHER: Psychiatri

 VASSAR BROTHERS HOSPITAL

   INPATIENT ACUTE CARE

$ 193.00

A,C, OTHER- Diagnostic

Radiology

ORANGE

 ARDEN HILL HOSPITAL

   INPATIENT ACUTE CARE

$ 223.00

A,C

 CORNWALL HOSPITAL

   INPATIENT ACUTE CARE

$ 170.00

A

 DOCTORS SUNNYSIDE HOSPITAL

   INPATIENT ACUTE CARE

$ 165.00

ALL INCLUSIVE

 E A HORTON MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 183.00

A

 FALKIRK HOSPITAL

   PSYCHIATRIC CARE

$ 125.00

ALL INCLUSIVE

 ST ANTHONY COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 187.00

A

 ST FRANCIS HOSPITAL OF PORT JERVIS NEW

 YORK

   INPATIENT ACUTE CARE

$ 185.00

A,C

 ST LUKES HOSPITAL OF NEWBURGH

   INPATIENT ACUTE CARE

$ 207.00

A

 TUXEDO MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 143.00

A

PUTNAM

 JULIA L BUTTERFIELD MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 94.00

ALL INCLUSIVE

 PUTNAM COMMUNITY HOSPITAL

   INPATIENT ACUTE CARE

$ 204.00

A

ROCKLAND

 COMMUNITY HOSPITAL OF ROCKLAND COUNTY

   INPATIENT ACUTE CARE

$ 129.00

A

 GOOD SAMARITAN HOSPITAL OF SUFFERN

   INPATIENT ACUTE CARE

$ 246.00

A

 HELEN HAYES HOSPITAL

   INPATIENT ACUTE CARE

$ 260.00

ALL INCLUSIVE

 NYACK HOSPITAL

   INPATIENT ACUTE CARE

$ 230.00

A,B

 SUMMIT PARK HOSPITAL-ROCKLAND COUNTY

 INFIRMARY

   INPATIENT ACUTE CARE

$ 251.00

ALL INCLUSIVE

   PSYCHIATRIC CARE

$ 119.00

ALL INCLUSIVE

SULLIVAN

 COMMUNITY GENERAL HOSPITAL OF SULLIVAN

 COUNTY

   INPATIENT ACUTE CARE

$ 256.00

A

 COMMUNITY GENERAL HOSPITAL OF SULLIVAN

 COUNTY G HERMAN DIV

   INPATIENT ACUTE CARE

$ 150.00

A

 HAMILTON AVENUE HOSPITAL

   INPATIENT ACUTE CARE

$ 138.00

A

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

[See table in printed version.]

WORKERS' COMPENSATION

HOSPITAL RATE SCHEDULE

NEW YORK CITY REGION

EFFECTIVE

DAILY

01/01/80 - 12/31/80

RATE

EXCLUSIONS:

ASTORIA GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 194.00

A,C, OTHER: EEG,

Nuclear Medicine

BAPTIST HOSPITAL OF NEW YORK

   INPATIENT ACUTE CARE

$ 144.00

A

BEEKMAN DOWNTOWN HOSPITAL

   INPATIENT ACUTE CARE

$ 273.00

A

BETH ISRAEL MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 344.00

A

BOOTH MEMORIAL MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 287.00

A

BOULEVARD HOSPITAL

   INPATIENT ACUTE CARE

$ 174.00

A

BRONX-LEBANON HOSPITAL CENTER-FULTON DIVISION

$ 304.00

A,C

   INPATIENT ACUTE CARE 1/1/80--2/15/80

   2/16/80--12/31/80

268.00

BROOKDALE HOSPITAL MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 317.00

A,C

BROOKLYN HOSPITAL

   INPATIENT ACUTE CARE

$ 286.00

A

CABRINI HEALTH CARE CTR

   INPATIENT ACUTE CARE

$ 273.00

A,C, OTHER: EEG,

EKG, Sonography

CALEDONIAN HOSPITAL OF THE CITY OF NY

   INPATIENT ACUTE CARE

$ 196.00

A

CALVARY HOSPITAL

   INPATIENT ACUTE CARE

$ 332.00

ALL INCLUSIVE

CATHOLIC MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 294.00

ALL INCLUSIVE

CMC ST JOHN'S QUEENS DIV

   INPATIENT ACUTE CARE

$ 294.00

A

COMMUNITY HOSPITAL OF BROOKLYN INC

   INPATIENT ACUTE CARE

$ 172.00

A Nuclear Medicine,

Ultra Sound

DEEPDALE GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 199.00

A,C

DOCTORS HOSPITAL INC

   INPATIENT ACUTE CARE

$ 223.00

A,C

DOCTORS HOSPITAL OF STATEN ISLAND

   INPATIENT ACUTE CARE

$ 204.00

A

FLATBUSH GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 196.00

ALL INCLUSIVE

FLUSHING HOSPITAL AND MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 256.00

A

GRACIE SQUARE GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 217.00

ALL INCLUSIVE

   PSYCHIATRIC CARE

$ 149.00

ALL INCLUSIVE

H I P HOSPITAL INC

   INPATIENT ACUTE CARE

$ 257.00

A

HILLCREST GENERAL HOSPITAL-GHI

   INPATIENT ACUTE CARE

$ 245.00

A

HOSPITAL FOR JOINT DISEASES AND MEDICAL CENTER

ORTHOPEDIC INSTI

   INPATIENT ACUTE CARE

$ 466.00

A

HOSPITAL FOR SPECIAL SURGERY

   INPATIENT ACUTE CARE

$ 328.00

A

INSTITUTE OF REHAB MEDICINE NY UNIVERSITY

REHABILITATION

$ 292.00

A,C,D

INTERBORO GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 221.00

A

JAMAICA HOSPITAL

   INPATIENT ACUTE CARE

$ 258.00

A,C

JEWISH HOSPITAL AND MEDICAL CENTER OF BROOKLYN

   INPATIENT ACUTE CARE

$ 258.00

A

JEWISH MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 198.00

A

JOINT DISEASES NORTH GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 239.00

A

KINGS HIGHWAY HOSPITAL

   INPATIENT ACUTE CARE

$ 203.00

A,C

KINGSBROOK JEWISH MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 254.00

A,B,C,D

LENOX HILL HOSPITAL

   INPATIENT ACUTE CARE

$ 324.00

A

LEROY HOSPITAL

   INPATIENT ACUTE CARE

$ 210.00

A

LONG ISLAND COLLEGE HOSPITAL

   INPATIENT ACUTE CARE

$ 319.00

A

LONG ISLAND JEWISH-HILLSIDE MED CTR

   INPATIENT ACUTE CARE

$ 342.00

A

LUTHERAN MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 298.00

A

MAIMONIDES MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 296.00

A

MANHATTAN EYE EAR AND THROAT HOSPITAL

   INPATIENT ACUTE CARE

$ 230.00

A,C

MEDICAL ARTS CENTER HOSPITAL

   INPATIENT ACUTE CARE

$ 199.00

A,C

MEMORIAL HOSPITAL FOR CANCER

 AND ALLIED DISEASES

   INPATIENT ACUTE CARE

$ 501.00

ALL INCLUSIVE

METHODIST HOSPITAL OF BROOKLYN

   INPATIENT ACUTE CARE

$ 267.00

A

MISERICORDIA HOSPITAL MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 230.00

A,D, OTHER:

Ambulance

MONTEFIORE HOSPITAL & MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 389.00

A

MOUNT SINAI HOSPITAL

   INPATIENT ACUTE CARE

$ 382.00

A,C

NY EYE AND EAR INFIRMARY

   INPATIENT ACUTE CARE

$ 252.00

A

NY INFIRMARY

   INPATIENT ACUTE CARE

$ 273.00

A

NY UNIVERSITY MEDICAL CENTER

   INPATIENT ACUTE CARE

$ 337.00

A,C

PARKWAY HOSPITAL

   INPATIENT ACUTE CARE

$ 218.00

A,C

PARSONS HOSPITAL

   INPATIENT ACUTE CARE

$ 181.00

A

PAYNE WHITNEY AND NEW YORK HOSPITAL COMBINED

   INPATIENT ACUTE CARE

$ 381.00

A

PELHAM BAY GENERAL HOSPITAL

   INPATIENT ACUTE CARE

$ 187.00

A,B,C, OTHER: EKG,

EEG

PENINSULA HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 220.00

A

PHYSICIANS HOSPITAL

   INPATIENT ACUTE CARE

$ 208.00

A

PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK

   INPATIENT ACUTE CARE

$ 351.00

A,B

PROSPECT HOSPITAL

   INPATIENT ACUTE CARE

$ 168.00

A

RICHMOND MEMORIAL HOSPITAL AND HEALTH CENTER

   INPATIENT ACUTE CARE

$ 215.00

A

ROCKEFELLER UNIVERSITY HOSPITAL

   INPATIENT ACUTE CARE

$ .00

ALL INCLUSIVE

ROOSEVELT HOSPITAL

   INPATIENT ACUTE CARE

$ 330.00

A

   DETOXIFICATION UNIT

$ 88.00

A

ST BARNABAS HOSPITAL

   INPATIENT ACUTE CARE

$ 236.00

ALL INCLUSIVE

ST CLARES HOSPITAL AND HEALTH CENTER

   INPATIENT ACUTE CARE

$ 246.00

A

ST ELIZABETHS DIVISION OF ST CLARES

HOSPITAL AND HEALTH CENTER

   INPATIENT ACUTE CARE

$ 246.00

A

ST JOHNS EPISCOPAL HOSPITAL

   INPATIENT ACUTE CARE

$ 236.00

A

ST JOHNS EPISCOPAL HOSPITAL-SO SHORE DIV

   INPATIENT ACUTE CARE

$ 236.00

A

ST LUKES HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 330.00

A

ST MARYS HOSPITAL OF BROOKLYN

   INPATIENT ACUTE CARE

$ 343.00

ALL INCLUSIVE

ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY

   INPATIENT ACUTE CARE

$ 315.00

A

ST VINCENTS MEDICAL CENTER OF RICHMOND

   INPATIENT ACUTE CARE

$ 272.00

ALL INCLUSIVE

STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL

CENTER

   INPATIENT ACUTE CARE

$ 275.00

A

STATEN ISLAND HOSPITAL

   INPATIENT ACUTE CARE

$ 288.00

A

TERRACE HEIGHTS HOSPITAL

   INPATIENT ACUTE CARE

$ 201.00

A

UNION HOSPITAL OF THE BRONX

   INPATIENT ACUTE CARE

$ 172.00

A,C

VICTORY MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 192.00

A

WESTCHESTER SQUARE HOSPITAL

   INPATIENT ACUTE CARE

$ 168.00

A,C, OTHER: Nuclear

WYCKOFF HEIGHTS HOSPITAL

   INPATIENT ACUTE CARE

$ 221.00

A,C

HEALTH AND HOSPITAL CORPORATION

BELLEVUE HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 298.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

$ 288.00

BIRD S COLER MEMORIAL HOSPITAL AND HOME

   INPATIENT ACUTE CARE

$ 229.00

ALL INCLUSIVE

BRONX MUNICIPAL HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 311.00

ALL INCLUSIVE

CITY HOSPITAL CENTER AT ELMHURST

   INPATIENT ACUTE CARE

$ 289.00

ALL INCLUSIVE

CONEY ISLAND HOSPITAL

   INPATIENT ACUTE CARE

$ 309.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

301.00

CUMBERLAND HOSPITAL

   INPATIENT ACUTE CARE

$ 336.00

ALL INCLUSIVE

GOLDWATER MEMORIAL HOSPITAL

   INPATIENT ACUTE CARE

$ 184.00

ALL INCLUSIVE

GREENPOINT HOSPITAL

   INPATIENT ACUTE CARE

$ 323.00

ALL INCLUSIVE

HARLEM HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 288.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

272.00

KINGS COUNTY HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 292.00

ALL INCLUSIVE

LINCOLN MEDICAL & MENTAL HEALTH CENTER

   INPATIENT ACUTE CARE

$ 382.00

ALL INCLUSIVE

METROPOLITAN HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 374.00

ALL INCLUSIVE

   EXCLUSING PHYSICIANS

358.00

NORTH CENTRAL BRONX HOSPITAL

   INPATIENT ACUTE CARE

$ 417.00

ALL INCLUSIVE

QUEENS HOSPITAL CENTER

   INPATIENT ACUTE CARE

$ 290.00

ALL INCLUSIVE

SYDENHAM HOSPITAL

   INPATIENT ACUTE CARE

$ 250.00

ALL INCLUSIVE

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST