AMENDMENT TO NATIONAL HOME CARE PROVIDER AGREEMENT

EXHIBIT 10.18

AMENDMENT TO
NATIONAL HOME CARE PROVIDER AGREEMENT

            THIS AMENDMENT is entered into this 1^st day of January, 2003 by and between CIGNA Health Corporation, for and on behalf of its subsidiaries and affiliates listed on Exhibit I (individually and collectively, "CIGNA"), and Olsten Network Management, Inc. d/b/a Gentiva Health Network, for and on behalf of its subsidiaries and affiliates listed on Exhibit II (individually and collectively, "Provider").

W I T N E S S E T H

            WHEREAS, CIGNA and Provider entered into a National Home Care Provider Agreement dated January 1, 1996 and amended from time to time (the Agreement), whereby Provider provided or arranged for the provision of certain health care services to Participants;

            WHEREAS, the parties wish to amend certain provisions of the Agreement as set forth below;

            NOW THEREFORE, CIGNA and Provider hereby agree as follows:

1.        Effective January 1, 2003, Exhibits A.1.A and A.1.B are deleted in their entirety and replaced by the new Exhibits of the same name and designation attached hereto.

2.        Effective January 1, 2003, Schedules 1A, 1B, 2A and 3A are deleted in their entirety and replaced by the new Schedules of the same name and designation attached hereto.

3.        Effective January 1, 2003, Xxxxxxxx X0, X0, X0 are deleted in their entirety and replaced by the new Exhibits of the same name and designation attached hereto.

4.        Effective January 1, 2003, Exhibits C1, C2, C3 are deleted in their entirety and replaced by the new Exhibits of the same name and designation attached hereto.

5.        All Exhibits and Schedules attached to this Amendment are incorporated by reference as though fully set forth in the Agreement.

6.        Both parties agree to be subject to and act in accordance with all applicable laws, rules and regulations governing their conduct under the Agreement.

7.        Provider shall provide CIGNA with the demographic data elements indicated on Attachment 1 to this Amendment for all of Provider's sub-contracted providers of covered services. CIGNA will load all subcontracted providers in all CIGNA claim platforms. All claims submitted to CIGNA by Provider's sub-contracted providers of covered services in the Provider sole source service area shall be denied for payment by CIGNA. A remark shall be placed on the PRA/EOB to instruct the subcontracted provider to resubmit the claim to Provider for consideration and determination as to whether the service is a covered capitated service or a service for which a fee has been established in the Agreement.  Any amounts paid by CIGNA to Provider's subcontracted providers for covered services shall be refunded to CIGNA by Provider within thirty (30) days of receipt of notice from CIGNA. CIGNA may, at its option, deduct from future payments required by CIGNA under the Agreement any amounts not refunded within thirty (30) days of notice from CIGNA.
 

8.        CIGNA will provide to Provider a quarterly retrospective claims paid report for non-participating providers within 105 days following the end of each quarter, to include the HMO, FLEXCARE, PPO and Indemnity populations.  Provider will review retrospective claims paid reports provided by CIGNA for the purpose of identifying providers of covered services not subcontracted with Provider.  Provider shall use reasonable commercial efforts, as evidenced by contracting results reporting as described on Attachment 2, to contract with providers of covered services not subcontracted with Provider.

9.        CIGNA will consider and make best efforts to implement a reasonable and customary fee schedule for covered services.

10.      The providers of covered services identified on the retrospective claims paid reports who were not subcontracted with Provider during the 2002 baseline period and subsequently participate with Provider in 2003 shall submit claims to Provider for consideration.  Provider shall xxxx CIGNA for such services and be reimbursed by CIGNA on a fee for service basis during the period 1/1/03 - 12/31/03. Claims paid experience for capitated services for this group of providers shall be incorporated into the baseline calculation in determining the 2004 capitation rate.

11.        Within thirty (30) days of execution of this Amendment, Provider will contact subcontracted providers identified on leakage reports provided by CIGNA for the purpose of instructing them to no longer send claims directly to CIGNA for covered services provided in the sole source service area.

12.        Provider will work directly with CIGNA Healthplans identified as incurring leakage on retrospective claims paid reports to educate the provider network and specifically identified participating providers regarding the provision of covered services.

13.        During 2003, Provider shall, in a periodic summary report in a format agreeable to both parties, notify CIGNA of any authorizations and re-authorizations provided to non-subcontracted providers of covered services.

14.        Provider shall notify CIGNA of all subcontractors added to the Provider network on a monthly basis. Monthly update shall include data elements indicated in Attachment 1.

15.        Provider will underwrite the cost of communications to mutually agreed upon participating providers and discharge planners in the Provider sole source service area identifying Provider as the sole source provider of covered services for CIGNA.

2

            To the extent that the provisions in the Agreement, including any prior amendments, conflict with the terms of this Amendment (including the exhibits and schedules hereto), the terms in this Amendment shall control. Except as amended hereby, all other terms and conditions of the Agreement, as previously amended, including the Program Attachments and the Exhibits attached thereto, shall remain the same and in full force and effect.  Capitalized terms not defined herein but defined in the Agreement shall have the same meaning as defined in the Agreement.

            This Amendment shall take effect commencing on January 1, 2003 and shall continue in force and effect for a period of one (1) year thereafter, or until terminated as provided herein or in accordance with the Agreement.

            IN WITNESS WHEREOF, CIGNA and Provider have caused their duly authorized representatives to execute this Amendment as of the date first written above.

CIGNA HEALTH CORPORATION

By:                                                                  

Its:                                                                   

Dated:                                                             

OLSTEN NETWORK MANAGEMENT, INC.

By:                                                                  

Its:                                                                   

Dated:                                                             

EXHIBIT A.1.A
Gentiva Health Network
COMMERCIAL HMO CAPITATION RATES
Effective January 1, 2003

These are the capitation rates that apply to services rendered to Patient Panel Participants enrolled in HMO Programs.  An "HMO Program" means a non-governmental, fully insured HMO or Point of Service product that is underwritten based on a community rating methodology (i.e. community rating, community rating by class, adjusted community rating by class).

			Gentiva Homehealth Infusion and DME/HME Capitation Rate PMPM
All Commercial HMO Capitated Affiliates			**

** Confidential Treatment Requested

EXHIBIT A.1.B
OLSTEN NETWORK MANAGEMENT
GATEKEEPER (FLEXCARE) CAPITATION RATES
EFFECTIVE DATE:  JANUARY 1, 2003

These are the capitation rates that apply to services rendered to Patient Panel Participants enrolled in Gatekeeper Programs.  A "Gatekeeper Program" means (i) a product that includes fully insured Standard HMO, Point of Service, or Gatekeeper PPO benefits and which is underwritten by a licensed insurance company based on an experience rating methodology, or (ii) a self funded product which includes Standard HMO, Point of Service, or Gatekeeper PPO benefits.  This definition includes, but is not limited to, Participants covered under FlexCare plans insured/administered by Connecticut General Life Insurance Company.

			Gentiva HomeHealth, Infusion, DME/HME Capitation Rates PMPM
All Gatekeeper (FlexCare) Capitated Affiliates			**

** Confidential Treatment Requested

Gentiva Health Network                SCHEDULE 1A: TRADITIONAL HOME HEALTH HMO/FLEX FEE-FOR-SERVICE RATES Effective January 1, 2003
The following Traditional Home Health Services have both Visit and Hourly rates.
Notes 1, 2, 3, 4, 5 and 6 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
CERTIFIED NURSES AIDE	**	**	**	**	**	**
HOME HEALTH  AIDE	**	**	**	**	**	**
LVN/LPN	**	**	**	**	**	**
LVN/LPN - HIGH TECH	**	**	**	**	**	**
PEDIATRIC HIGH TECH LVN/LPN	**	**	**	**	**	**
PEDIATRIC HIGH TECH RN	**	**	**	**	**	**
PEDIATRIC LVN/LPN	**	**	**	**	**	**
PEDIATRIC RN	**	**	**	**	**	**
RN	**	**	**	**	**	**
RN HIGH TECH  INFUSION	**	**	**	**	**	**
RN HIGH TECH OTHER	**	**	**	**	**	**

The following Traditional Home Health Services have Visit only rates.
Notes 1, 3, 4, 5, 7 and 8 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
DIABETIC NURSE	**	N/A	**	N/A	**	N/A
DIETITIAN	**	N/A	**	N/A	**	N/A
ENTEROSTOMAL THERAPIST	**	N/A	**	N/A	**	N/A
MATERNAL CHILD HEALTH	**	N/A	**	N/A	**	N/A
MEDICAL SOCIAL WORKER	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PHLEBOTOMIST	**	N/A	**	N/A	**	N/A
PHOTOTHERAPY PACKAGE SERVICE	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PSYCHIATRIC NURSE	**	N/A	**	N/A	**	N/A
REHABILITATION NURSE	**	N/A	**	N/A	**	N/A
RESPIRATORY THERAPIST	**	N/A	**	N/A	**	N/A
RN ASSESSMENT, INITIAL	**	N/A	**	N/A	**	N/A
RN SKILLED NURSING ADMISSION VISIT	X/X	X/X	X/X	X/X	X/X	X/X
RN SKILLED NURSING VISIT-EXTENSIVE	**	N/A	**	N/A	**	N/A
SPEECH THERAPIST	**	N/A	**	N/A	**	N/A

The following Traditional Home Health Service has Hourly only rates.
Notes 3, 4 and 5 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
HOMEMAKER	N/A	**	N/A	**	N/A	**

The following Traditional Home Health Service is priced on a Per Diem basis.
Notes 3, 4 and 5 apply	Xxxx 0		Xxxx 0		Xxxx 0
		Per Diem		Per Diem		Per Diem
COMPANION/LIVE IN		**		**		**

NOTES:

1.   Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration).

2.   Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3.

3.   CIGNA does not reimburse for travel time, weekend, holiday or evening differentials.

4.   Above prices have no exclusions.

5.   All services not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT.

7.   Respiratory Therapist visit utilization/costs to be reported with HME/RT.

8.   Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment.  Use requires special coordination.

** Confidential Treatment Requested

Gentiva Health Network SCHEDULE 1B:  TRADITIONAL HOME HEALTH ZONE RATE AREAS Effective January 1, 2003
STATE	RATE AREA	RATE DESIGNATION
Alabama	LOW	3
Alaska	HIGH	1
Arizona	MEDIUM	2
Arkansas	LOW	3
California	HIGH	1
Colorado	MEDIUM	2
Connecticut	MEDIUM	2
Delaware	LOW	3
District of Columbia	HIGH	1
Florida	MEDIUM	2
Georgia	MEDIUM	2
Hawaii	HIGH	1
Idaho	LOW	3
Illinois	HIGH	1
Indiana	LOW	3
Iowa	LOW	3
Kansas	LOW	3
Kentucky	LOW	3
Louisiana	MEDIUM	2
Maine	LOW	3
Maryland	MEDIUM	2
Massachusetts	HIGH	1
Michigan	LOW	3
Minnesota	LOW	3
Mississippi	LOW	3
Missouri	MEDIUM	2
Montana	LOW	3
Nebraska	LOW	3
Nevada	LOW	3
New Hampshire	LOW	3
New Jersey	MEDIUM	2
New Mexico	LOW	3
New York	MEDIUM	2
North Carolina	MEDIUM	2
North Dakota	MEDIUM	2
Ohio	MEDIUM	2
Oklahoma	LOW	3
Oregon	MEDIUM	2
Pennsylvania	MEDIUM	2
Rhode Island	MEDIUM	2
South Carolina	MEDIUM	2
South Dakota	LOW	3
Tennessee	MEDIUM	2
Texas	HIGH	1
Utah	MEDIUM	2
Vermont	LOW	3
Virginia	MEDIUM	2
Washington	MEDIUM	2
West Virginia	LOW	3
Wisconsin	LOW	3
Wyoming	LOW	3

Schedule 2A: Home Infusion Therapy HMO/FLEX Fee-For-Service Rates
Effective January 1, 2003

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem	Primary or Multiple Therapy Dispensing Fee	Primary or Multiple Therapy Drug Discount off AWP
Ancillary Drugs		**	-15%
Biological Response Modifiers		**	-13%
Cardiac (Inotropic) Therapy	**		-15%
Chelation Therapy	**		-15%
Chemotherapy	**		-15%
Enteral Therapy	**		N/A
Enzyme Therapy	**		0%
Growth Hormone		**	-13%
IV Immune Globulin	**		0%
Other Injectable Therapies		**	-13%
Other Infusion Therapies	**		-15%
Pain Management Therapy	**		-15%
Steroid Therapy	**		-15%
Thrombolytic (Anticoagulation) Therapy	**		-15%
Synagis		**	-13%
Remodulin Therapy	**		-3%

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple anti-infective therapies
Anti-Infectives - Primary Anti-Infective	**		-15%
Anti-Infectives - Multiple Anti-Infective	**		-15%

The following Home Infusion Therapy service rate EXCLUDES drugs.  Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective therapies
	Primary or Multiple Therapy Per Diem		Cost of Drug
Flolan Therapy	**
Flolan 0.5 mg vial			AWP
Flolan 1.5 mg vial			AWP
Flolan diluent vial			AWP

The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem
Enteral Therapy	**
Hydration Therapy	**
Total Parenteral Nutrition	**

**  Confidential Treatment Requested

SCHEDULE 2A, PAGE 2:  HOME INFUSION THERAPY RATE SCHEDULE

NOTES:

1.  Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.

2.   Per Diems INCLUDING drugs include ALL costs - including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.

3.   "DISPENSING FEE" is defined as per each time the drug is dispensed by the home infusion provider.

4.   "PER DIEM" costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES.

5.   The per diem rate shall only be charged for those days the Participant receives medication.

6.   For home infusion pharmaceuticals not listed on fee schedule, AWP less 15% will apply.

7.   Case Managers should utilize Enteral Therapy WITHOUT drugs as an infusion benefit infrequently.  Generally, patient's requiring Enteral Therapy WITHOUT drugs should have services coordinated through the DME benefit.

** Confidential Treatment Requested

The following are for the stated item ONLY.  Unless otherwise noted, nursing, supplies, etc. are NOT included.
Blood Transfusion Per Unit (Tubing, Filters)			**
Catheter Care Per Diem			**
Midline Insertion (Catheter & Supplies)			**
PICC Line Insertion (Catheter & Supplies)			**
Blood Product			COST PLUS 10%

** Confidential Treatment Requested

SCHEDULE 2A, PAGE 3:  HOME INFUSION THERAPY RATE SCHEDULE

Factor Concentrates
		Vial price	Unit Price
Factor VII
Novoseven 1200MCG Vial		**
Novoseven 4800MCG Vial		**
Novoseven in 1200MCG or 4800MCG QTY			**
Factor VIII (Recombinant)
Recombinate			**
Kogenate or Helixate			**
Bioclate			N/A
Helixate FS			**
Kogenate FS			**
Refacto			**
Factor VIII (Monoclonal)
Hemofil-M or A. R. C. Method M			**
Monoclate P			**
Monarc-M			**
Factor VIII (Other)
Koate			**
Humate			**
Alphanate SDHT			**
Factor IX (Recombinant)
BeneFix			**
Factor IX (Monoclonal/High Purity)
Mononine			**
Alphanine			**
Factor IX (Other)
Konyne - 80			N/A
Proplex T			**
Bebulin			**
Profilnine SD			**
Anti-Inhibitor Complex
Autoplex-T			**
Feiba-VH			**
Hyate-C			**
HEMOSTATIC AGENTS
DDAVP - 10ml vial			AWP - 10%
Stimate  - 2.5xx xxxx			AWP - 10%
Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support; home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation

** Confidential Treatment Requested

GENTIVA HEALTH SERVICES CARECENTRIX SCHEDULE 3A:  HOME MEDICAL EQUIPMENT/RESPIRATORY THERAPY HMO/FLEX FEE-FOR-SERVICE SCHEDULE EFFECTIVE DATE:  JANUARY 1, 2003
HCPCS CODE	CHC CODE	GENTIVA CODE	DESCRIPTION	PURCHASE PRICE	RENTAL PRICE	DAILY PRICE
A4660	DM590	2520	MONITOR, BLOOD PRESSURE (A4660) W/STETH & CUFF	**
A4670	DM590	2518	MONITOR, BLOOD PRESSURE (A4670) , AUTOMATIC	**
A9900	A9900	7552	BREEZE (A9900) CPAP/BIPAP MASK	**
A9900	A9900	7553	FULL FACE (A9900) MIRAGE CPAP/BIPAP MASK	**
A9900	A9900	7554	GEL/SILICON (A9900) CPAP/BIPAP MASK INCL GLD SEAL,PHANTM,MONARCH	**
A9900	A9900	7556	SPECIALTY (A9900) CPAP/BIPAP MASK (PROFILE OR SIMPICITY)	**
DM590	HI531	2570	PUMP, ENTERAL (B9002)	**	**
B9998	DM590	6828	ENTERAL SUPPLIES (B9998)			COST+10%
DM590	DM570	7551	BACK-PACK (E1399),  FOR PORTABLE ENTERAL PUMP	**
DM590	DM590	2522	CANNULA, NASAL	COST+10%
DM590	DM590	7509	ENTERAL PUMP, PORTABLE (B9002)	COST+10%	COST+10%
DM590	DM590	7508	MASK, CPAP GEL OR SILICONE (K0183)	COST+10%
E0100	E0100	2020	CANE (E0100), ADJ OR FIX, W/ TIP	**
E0105	E0105	2021	CANE, QUAD (E0105)  OR THREE PRONG, ADJ OR FIX, W/ TIPS	**
E0110	E0110	2028	CRUTCHES, FOREARM (E0110),  ADJ OR FIX, PAIR, W/ TIPS, GRIPS	**
E0111	E0111	2023	CRUTCH FOREARM (E0111),  ADJ OR FIX, EACH, W/ TIP AND GRIPS	**
E0112	E0112	2027	CRUTCHES UNDERARM,  WOOD (E0112), ADJ OR FIX, PAIR, COMPLETE	**
E0113	E0113	2025	CRUTCH UNDERARM, WOOD (E0113),  ADJ OR FIX, EACH, COMPLETE	**
E0114	E0114	2026	CRUTCHES UNDERARM, ALUM (E0114),  ADJ OR FIX, PAIR, COMPLETE	**
E0116	E0116	2024	CRUTCH UNDERARM, ALUM (E0116),  ADJ OR FIX, EACH, COMPLETE	**
E0130	E0130	2037	XXXXXX, RIGID (E0130)  (PICKUP), ADJ OR FIX HEIGHT	**
E0135	E0135	2036	XXXXXX, FOLDING (E0135)  (PICKUP),  ADJ OR FIX HEIGHT	**
E0141	E0141	2040	XXXXXX, WHEELED (E0141),  W/OUT SEAT	**
E0142	DM570	2034	RIGID XXXXXX (E0142), WHEELED, W/ SEAT	**
E0143	E0143	2029	XXXXXX FOLDING, WHEELED (E0143), W/OUT SEAT	**
E0145	DM570	2039	XXXXXX (E0145), WHEELED, W/ SEAT AND CRUTCH ATTACHMENTS	**
E0146	DM570	2038	XXXXXX, WHEELED, W/ SEAT (E0146)	**
E0147	E0147	2030	XXXXXX HVY DUT (E0147),  MULT BRAKING SYS, VAR WHEEL RESISTANCE	**
E0153	E0153	2032	CRUTCH PLATFORM ATTACHMENT (E0153), FOREARM EA	**
E0154	E0154	2033	XXXXXX PLATFORM ATTACHMENT (E0154), EA	**
E0155	E0155	2041	XXXXXX WHEEL ATTACHMENT (E0155), RIGID (PICKUP) XXXXXX	**
E0156	DM570	2035	XXXXXX SEAT ATTACHMENT (E0156)	**
E0157	E0157	2022	XXXXXX, CRUTCH ATTACHMENT (E0157), EACH	**
E0158	E0158	2031	XXXXXX LEG EXTENSIONS (E0158)	**
E0163	E0163	2047	COMMODE CHAIR, STATIONARY  (E0163),  W/ FIX ARMS	**
E0164	E0164	2045	COMMODE CHAIR, MOBILE  (E0164),  W/ FIX ARMS	**
E0165	E0165	2046	COMMODE CHAIR (E0165), STATIONARY, W/ DETACH ARMS	**
E0165	E0165	2591	COMMODE, XXWIDE(E0165)	**
E0166	E0166	2044	COMMODE CHAIR (E0166), MOBILE, W/ DETACH ARMS	**
E0167	E0167	2051	COMMODE CHAIR, PAIL OR PAN (E0167)	**
E0176	E0176	2142	CUSHION (E0176) OR AIR PRESSURE PAD, NON-POSITIONING	**
E0176	E0176	2394	REPLACEMENT PAD (E0176) ALTERNATING PRESS	**
E0177	E0177	2224	CUSHION OR WATER PRESS PAD (E0177), NONPOSITIONING	**
E0178	E0178	2160	CUSHION OR GEL PRESS PAD (E0178), NONPOSITIONING	**
E0179	E0179	2154	CUSHION (E0179) OR DRY PRESSURE PAD, NONPOSTIONING	**
E0180	E0180	2196	PUMP (E0180), ALTERNATING PRESSURES W/PAD	**	**
E0181	E0181	2197	PUMP (E0181), ALTERNATING PRESS W/PAD,  HVY DUTY	**	**
E0184	E0184	2074	MATTRESS, DRY PRESSURE (E0184)	**
E0185	E0185	2076	MATTRESS (E0185), GEL OR GEL-LIKE PRESSURE PAD	**
E0186	E0186	2064	MATTRESS, AIR PRESSURE (E0186)	**
E0187	E0187	2099	MATTRESS, WATER PRESSURE (E0187)	**
E0188	DM570	2217	PAD, SYNTHETIC SHEEPSKIN (A9900)	**
E0189	DM570	2177	PAD, LAMBSWOOL SHEEPSKIN (E0189), ANY SIZE	COST+10%
E0192	E0192	2573	CUSHION, XXX FOR W/C (E0192)	**	**
E0192	E0192	2572	CUSHION, ROHO FOR W/C  (E0192)	**	**
E0192	E0192	2178	W/C PAD (E0192), LOW PRESS AND POSITIONING EQUALIZATION	**	**
E0193	E0193	2098	MATTRESS, LOW AIR LOSS (E0193), INCL. BED	**	**	**
E0194	DM570	2063	AIR FLUIDIZED BED (E0194)		**	**
E0196	E0196	2077	MATTRESS, GEL PRESSURE (E0196)	**
E0197	E0197	2065	MATTRESS, AIR PRESSURE PAD (E0197)	**
E0198	E0198	2100	MATTRESS (E0198), WATER PRESSURE PAD	**
E0199	E0199	2075	MATTRESS, DRY PRESSURE PAD (E0199)	**
E0200	E0200	2228	HEAT LAMP (E0200),  W/OUT STAND, INCL/BULB, OR INFRARED ELEMENT	**
E0202	E0202	2229	PHOTOTHERAPY (BILIRUBIN) (E0202), LIGHT WIT			**
E0202	E0202	2524	PHOTOTHERAPY, BILI BLANKET (E0202)			**
E0205	E0205	2227	HEAT LAMP (E0205), WITH STAND, INCL/ BULB, OR INFRARED ELEMENT	**
E0210	DM570	2156	HEATING PAD, STANDARD (E0210)	**
E0215	DM570	2155	HEATING PAD (E0215), ELECTRIC, MOIST	**
E0218	DM570	2560	COLD THERAPY UNIT (E0218)	**	**	**
E0235	DM570	2187	PARAFFIN BATH UNIT, PORT (E0235)	**
E0236	DM570	2199	PUMP (E0236) FOR WATER CIRCULATING PAD	**
E0237	DM570	2223	HEAT COLD WATER (E0237) CIRCULATING PAD W/PUMP	**
E0238	DM570	2179	HEATING PAD (E0238), MOIST, NON-ELECTRIC	**
E0241	DM570	2867	BATH TUB RAIL (E0241), WALL, L-SHAPE	**
E0241	DM570	2862	BATH TUB RAIL, WALL, 12" (E0241)	**
E0241	DM570	2863	BATH TUB RAIL, WALL, 16" (E0241)	**
E0241	DM570	2864	BATH TUB RAIL, WALL, 18" (E0241)	**
E0241	DM570	2865	BATH TUB RAIL, WALL, 24" (E0241)	**
E0241	DM570	2866	BATH TUB RAIL, WALL, 36" (E0241)	**
E0241	DM570	2043	BATH TUB RAIL, WALL, UNSPECIFIED SIZE	COST+10%
E0242	DM570	2042	BATH TUB RAIL, FLOOR BASE (E0242)	**
E0243	DM570	2056	TOILET RAIL, EACH (E0243)	**
E0244	E0244	2587	TOILET SEAT (E0244) RAISED WITH ARMS	**
E0244	E0244	2052	TOILET SEAT, RAISED (E0244)	**
E0245	DM570	2575	BATH BENCH WITH BACK (E0245)	**
E0245	DM570	2058	BATH TUB STOOL OR BENCH (E0245)	**
E0245	DM570	2578	TRANSFER BENCH, NON-PADDED (E0245)	**
E0245	DM570	2577	TRANSFER BENCH, PADDED (E0245)	**
E0246	DM570	2057	TRANSFER TUB RAIL(E0246), ATTACHMENT	**
E0249	DM570	2186	HEAT UNIT (E0249), WATER CIRCULATING PAD	**
E0255	E0255	2090	HOSP BED (E0255), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/ MATTRESS	**	**
E0256	E0256	2091	HOSP BED (E0256), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/O MATTRESS	**	**
E0260	E0260	2083	HOSP BED (E0260), SEMI-ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0261	E0261	2084	HOSP BED (E0261), SEMI-ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0265	E0265	2086	HOSP BED (E0265), TOTAL ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0266	E0266	2087	HOSP BED (E0266), TOTAL ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0271	E0271	2096	MATTRESS, INNERSPRING (E0271)	**
E0272	E0272	2095	MATTRESS, FOAM RUBBER (E0272)	**
E0273	DM570	2068	BED BOARD (E1399)	**
E0274	DM570	2097	OVER-BED TABLE (E0274)	**
E0275	E0275	2071	BED PAN, STANDARD (E0275), METAL OR PLASTIC	**
E0276	E0276	2070	BED PAN, FRACTURE (E0276), METAL OR PLASTIC	**
E0277	E0277	2066	MATTRESS (E0277), LOW AIR LOSS, ALT PRESSURE	**	**
E0280	DM570	2069	BED CRADLE, ANY TYPE (E1399)	**
E0292	E0292	2092	HOSP BED (E0292), VAR HEIGHT, HI-LO, W/OUT S/ RAILS, W/ MATTRESS	**	**
E0293	E0293	2093	HOSP BED (E0293), VAR HEIGHT, HI-LO,  NO SIDE RAILS, NO MATTRESS	**	**
E0294	E0294	2085	HOSP BED (E0294), SEMI-ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0295	E0295	2094	HOSP BED (E0295), SEMI-ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0296	E0296	2089	HOSP BED (E0296), TOTAL ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0297	E0297	2088	HOSP BED (E0297), TOTAL ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0305	E0305	2073	BED SIDE RAILS (E0305), HALF LENGTH	**
E0310	E0310	2072	BED SIDE RAILS (E0310), FULL LENGTH	**
E0315	DM570	2067	BED ACCESSORIES: BOARDS OR TABLES, ANY TYPE	COST+10%
E0325	E0325	2060	URINAL; MALE (E0325), JUG-TYPE, ANY MATERIAL	**
E0326	E0326	2059	URINAL; FEMALE (E0326), JUG-TYPE, ANY MATERIAL	**
E0372	E0372	7008	MATTRESS (E0372) POWERED AIR OVERLAY		**	**
E0410	E0444	2369	O2 CONTENTS, LIQUID (E0444), PER POUND	**
E0416	E0443	2371	O2 REFILL FOR PORT (E0443) GAS SYSTEM ONLY, UP TO 23 CUBIC FEET	**
E0424	E0424	2385	O2 SYS STATIONARY (E0424) COMPR GAS, RENT		**
E0430	E0430	2374	O2 SYS PORT GAS, PURCH (E0430)	**
E0431	E0431	2574	O2 SYS PORT GAS, LIGHTWEIGHT (E0431) W/CONSERV DEVICE,NO CONTENT	**	**
E0431	E0431	2375	O2 SYS PORT GAS, RENT (E0431)		**
E0434	E0434	2377	O2 SYS PORT LIQUID,RENT (E0434)		**
E0435	E0435	2376	O2 SYS PORT LIQUID, PURCH (E0435)	**
E0439	E0439	2388	O2 SYS STATIONARY (E0439) LIQUID, RENT		**
E0440	E0440	2387	O2 SYS STATIONARY (E0440) LIQUID, PURCH	**
E0443	E0400	2869	O2 CONTENTS, H/K CYLINDER (E0400), 200-300 CUBIC FT	**
E0444	E0444	2379	O2 CONTENTS, PORT LIQUID (E0444), PER UNIT (1 UNIT = 1 LB.)	**
E0450	E0450	7555	POSITIVE PRESSURE VENTS (E0450)(E.G. T-BIRD)		**
E0450	E0450	2392	VENTILATOR VOLUME (E0450), STATIONARY OR PORT	**	**
E0450	E0450	7522	VENTILATOR, VOLUME, (E0450) EMERGENCY BACKUP UNIT	COST+10%	**
E0452	E0452	2332	BILEVEL INTERMITTENT (E0452) ASSIST DEVICE,(BIPAP)	**	**
E0453	E0453	2390	VENTILATOR THERAPEUTIC (E0453); FOR USE 12 HOURS OR LESS PER DAY	**	**
E0455	E0455	2372	O2 TENT (E0455), EXCLUDING CROUP OR PEDIATRIC TENTS	**	**
E0457	E0457	2323	CHEST SHELL (CUIRASS) (E0457)	**	**
E0459	E0459	2324	CHEST WRAP (E0459)	**	**
E0460	E0460	2339	VENTILATOR (E0460), NEGATIVE PRESSURE , PORTABLE OR STATIONARY	**	**
E0480	DM570	2373	PERCUSSOR (E0480), ELEC OR PNEUM, HOME MODEL	**	**
E0500	E0500	0000	XXXX , W/ BUILT-IN NEB (E0500) MAN OR AUTO VALVES; INT/EXT POWER	**	**
E0550	E0550	2328	HUMIDIFIER (E0550) DURABLE FOR EXTENSIV SUP/ HUMID W/ IPPB OR O2	**	**
E0555	E0555	2330	HUMIDIFIER (E0555), DURABLE, GLASS, FOR USE W/ REG OR FLOWMETER	COST+10%
E0565	E0565	2325	COMPRESSOR, AIR POWER (E0565)	**	**
E0570	E0570	2336	NEBULIZER, W/ COMPRESSOR (E0570)	**
E0575	DM570	2571	NEBULIZER (E0575), ULTRASONIC, AC/DC	**	**
E0575	DM570	2338	NEBULIZER; ULTRASONIC (E0575)	**	**
E0585	E0585	2337	NEBULIZER(E0585), W/ COMPRESSOR AND HEATER	**	**
E0600	E0600	2389	SUCTION PUMP (E0600), HOME MODEL	**	**
E0600	E0600	7523	SUCTION UNIT, (E0600), PORTABLE AC/DC	COST+10%	COST+10%
E0601	E0601	2326	CONTINUOUS POSITVE (E0601) AIRWAY PRESSURE DEVICE (CPAP)	**	**
E0601	E0601	6965	CPAP, SELF TITRATING (E0601)	**	**
E0605	DM570	2391	VAPORIZER, ROOM TYPE (E0605)	**
E0606	DM570	2380	POSTURAL DRAINAGE BOARD (E0606)	**
E0607	E0607	6874	MONITOR, B/GLUCOSE (E0607) ACCUCHEK AD	**
E0607	E0607	2164	MONITOR, BLOOD GLUCOSE (E0607)	**
E0608	E0608	2322	APNEA MONITOR (E0608)	**	**
E0608	E0608	2576	APNEA MONITOR (E0608) W/MEM (INCL SMART)	**	**
E0609	E0609	2146	MONITOR, BLOOD GLUCOSE (E0609) W/SPECIAL FEATURES	**
E0621	E0621	2215	PATIENT LIFT (E0621), SLING OR SEAT, CANVAS OR NYLON	**
E0625	DM570	2191	PATIENT LIFT (E0625), KARTOP, BATHROOM OR TOILET	COST+10%
E0627	E0627	4553	HIP CHAIR (E0627)	**	**
E0627	DM570	2395	SEAT LIFT CHAIR/MOTORIZED (E0627)	**
E0627	DM570	2205	SEAT LIFT MECH (E0627)  INCORPORATED INTO A COMB LIFT-CHAIR MECH	**
E0630	E0630	2190	PATIENT LIFT, HYDRAULIC (E0630), W/ SEAT OR SLING	**	**
E0635	DM570	2189	PATIENT LIFT (E0635), ELEC W/ SEAT OR SLING	**
E0650	E0650	2192	PNEUM COMPRESSOR (E0650), NON-SEG HOME MODEL	**	**
E0651	E0651	2194	PNEUM COMPRESSOR (E0651), SEG HOME MODEL W/OUT CALIB GRAD PRES	**	**
E0652	E0652	2193	PNEUM COMPRESSOR (E0652), SEG HOME MODEL W/ CALIB GRAD PRES	**	**
E0655	E0655	2182	PNEUM COMPRESSOR (E0655), NON-SEG APPLIANCE, HALF ARM	**
E0660	E0660	2181	PNEUM COMPRESSOR (E0660), NON-SEG APPLIANCE, FULL LEG	**
E0665	E0665	2180	PNEUM COMPRESSOR (E0665), NON-SEG APPLIANCE, FULL ARM	**
E0666	E0666	2183	PNEUM COMPRESSOR (E0666), NON-SEG APPLIANCE, HALF LEG	**
E0667	E0667	2210	PNEUM APPLIANCE (E0667), SEG, FULL LEG	**
E0668	E0668	2209	PNEUM APPLIANCE (E0668), SEG, FULL ARM	**
E0669	E0669	2212	PNEUM APPLIANCE (E0669), SEG, HALF LEG	**
E0670	E0670	2211	PNEUM APPLIANCE (E0670), SEG, HALF ARM	**
E0671	E0671	2207	PNEUM APPLIANCE (E0671), SEG GRAD PRESS, FULL LEG	**
E0672	E0672	2206	PNEUM APPLIANCE (E0672), SEG GRAD PRESS, FULL ARM	**
E0673	E0673	2208	PNEUM APPLIANCE (E0673), SEG GRAD PRESS, HALF LEG	**
E0690	DM570	2221	ULTRAVIOLET CABINET (E0690), APPROPRIATE FOR HOME USE	**
E0700	DM570	2204	SAFETY EQUIP (E0700) (E.G., BELT, HARNESS OR VEST)	COST+10%
E0710	DM570	2202	RESTRAINTS (E0710), ANY TYPE (BODY, CHEST, WRIST OR ANKLE)	**
E0720	E0720	2219	TENS (E0720), TWO LEAD, LOCALIZED STIMULATION	**	**
E0730	E0730	2218	TENS (E0730), FOUR LEAD, LARGER AREA/MULTIPLE NERVE STIMULATION	**	**
E0731	E0731	2159	TENS OR NMES (E0731), CONDUCTIVE GARMENT	**
E0744	E0744	2120	STIMULATOR (E0744), NEUROMUSCULAR FOR SCOLIOSIS	**	**
E0745	E0745	2121	STIMULATOR (E0745), NEUROMUSCULAR, ELECTRONIC SHOCK UNIT	**	**
E0745	E0745	6915	STIMULATOR FOUR CH (E0745), NEUROMUSCULAR	**	**
E0746	DM570	2109	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	**	**
E0747	DM570	2122	STIMULATOR (E0747), OSTEOGENIC, NON-INVASIVE	**
E0748	DM570	2124	STIMULATOR (E0748), OSTEOGENIC NON-INVASIVE, SPINAL APPLICATIONS	**
E0755	DM570	2157	STIMULATOR (E0755), ELECTRONIC SALIVARY REFLEX, NON INVASIVE	**
E0776	E0776	2175	IV POLE (E0776)	**	**
E0784	E0784	2158	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	**
E0784	E0784	6771	PUMP (E0784), INSULIN EXT INFUSION DISETRONICS OR OTHER	**
E0840	E0840	2133	TRACTION FRAME (E0840), ATTACH TO HEADBOARD, CERVICAL TRACTION	**
E0850	E0850	2134	TRACTION STAND (E0850), FREE STANDING, CERVICAL TRACTION	**	**
E0855	E0855	7484	TRACTION (E0855), W/O FRAME OR STAND	COST+10%
E0860	E0860	2130	TRACTION EQUIP (E0860), OVERDOOR, CERVICAL	**
E0870	E0870	2131	TRACTION FRAME (E0870), ATTACH TO FOOTBOARD, EXTREMITY, BUCKS	**	**
E0880	E0880	2135	TRACTION STAND (E0880) FREE/STAND EXTREMITY TRACTION, EG, BUCK'S	**	**
E0890	E0890	2132	TRACTION FRAME (E0890), ATTACH TO FOOTBOARD, PELVIC TRACTION	**	**
E0900	E0900	2136	TRACTION STAND (E0900) FREE/ STAND PELVIC TRACTION,( EG, BUCK'S)	**	**
E0910	E0910	2138	TRAPEZE BARS (E0910), A/K/A PT HELPER, ATTACH TO BED W/ GRAB BAR	**	**
E0920	E0920	2111	FRACTURE FRAME (E0920), ATTACH TO BED, INCLUDING WEIGHTS	**	**
E0935	E0935	2125	PASSIVE MOTION (E0935) EXERCISE DEVICE			**
E0935	E0935	2859	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE			**
E0935	E0935	2860	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW			**
E0935	E0935	2857	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND			**
E0935	E0935	2858	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER			**
E0935	E0935	2861	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST			**
E0940	E0940	2137	TRAPEZE BAR (E0940), FREE STANDING, COMPLETE W/ GRAB BAR	**	**
E0941	E0941	2116	TRACTION DEVICE (E0941), GRAVITY ASSISTED	**	**
E0942	E0942	0000	XXXXXXX/XXXXXX (E0942), CERVICAL HEAD	**
E0944	E0944	2126	HARNESS (E0944), PELVIC BELT, BOOT	**
E0945	DM570	2110	HARNESS (E0945), EXTREMITY BELT	**	**
E0946	E0946	2115	FRACTURE, FRAME (E0946), DUAL W/ CROSS BARS, ATTACH TO BED	**	**
E0947	E0947	2113	FRACTURE FRAME (E0947), ATTACHMENTS FOR COMPLEX PELVIC TRACTION	COST+10%	COST+10%
E0948	E0948	2112	FRACTURE FRAME (E0948) ATTACHMENTS FOR COMPLEX CERVICAL TRACTION	COST+10%	COST+10%
E0950	DM570	2139	TRAY (E0950)	**
E0958	E0958	2307	W/C PART ATTACHMENT (E0958) TO CONVERT ANY W/C TO ONE ARM DRIVE	**
E0959	E0959	2237	W/C PART AMPUTEE ADAPTER(E0959) (COMPENSATE FOR TRANS OF WEIGHT)	**
E0962	E0962	2232	CUSHION FOR WC 1" (E0962)	**
E0963	E0963	2233	CUSHION FOR WC 2" (E0963)	**
E0964	E0964	2234	CUSHION FOR WC 3" (E0964)	**
E0965	E0965	2235	CUSHION FOR WC 4" (E0965)	**
E0972	DM570	2230	TRANSFER BOARD OR DEVICE (E0972)	**
E0977	E0977	2317	CUSHION, WEDGE FOR W/C (E0977)	**
E0978	E0978	2248	BELT, SAFETY (E0978) W/ AIRPLANE BUCKLE, W/C	**
E0979	DM570	2249	BELT, SAFETY (E0979) W/ VELCRO CLOSURE, W/C	**
E0980	DM570	2292	SAFETY VEST (E0980), W/C	**
E1031	E1031	2291	ROLLABOUT CHAIR (E1031), W/ CASTORS 5" OR GREATER	**	**
E1050	E1050	2260	W/C FULL/REC (E1050), FIX ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1060	E1060	2259	W/C FULL/REC (E1070), DETACH ARMS, SWING AWAY DETACH FOOTREST	**	**
E1065	E1065	2287	W/C POWER ATTACHMENT (E1065)	**
E1066	E1066	2247	BATTERY CHARGER (E1066)	**
E1069	E1069	2255	BATTERY, DEEP CYCLE (E1069)	**
E1070	E1070	2258	W/C FULL/REC (E1060), DETACH ARMS, SWING AWAY DET/ ELEV LEGRESTS	**	**
E1083	E1083	2263	W/C HEMI (E1083), FIX ARMS, SWING AWAY DETACH ABLE ELEV LEG REST	**	**
E1084	E1084	2262	W/C HEMI (E1084), DETACH ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1085	E1085	2264	W/C HEMI (E1085), FIX ARMS, SWING AWAY DETACH ABLE FOOT RESTS	**	**
E1086	E1086	2261	W/C HEMI (E1086), DETACH ARMS, SWING AWAY DETACH FOOTRESTS	**	**
E1087	E1087	2265	W/C HI STRENGTH  LT-WT (E1087), FIX ARMS, S/AWAY  ELEV LEG RESTS	**	**
E1088	E1088	2268	W/C HI STRENGTH LT-WGT (E1088), D/ ARMS, S/AWAY ELEV LEG RESTS	**	**
E1089	E1089	2266	W/C HI STRENGTH LT-WGT (E1089), FIX ARMS, S/AWAY DETACH FOOTREST	**	**
E1090	E1090	2267	W/C HI STRENGTH XX-XX (E1090), DETACH ARMS, S/AWAY D/FOOT RESTS	**	**
E1091	E1091	2321	W/C YOUTH, ANY TYPE (E1091)	**	**
E1092	E1092	2319	W/C WIDE HVY DUTY (E1092), DETACH ARMS S/AWAY DETACH ELEVAT LEGS	**	**
E1093	E1093	2320	W/C WIDE HVY DUTY (E1093), DETACH ARMS S/AWAY DETACH FOOTRESTS	**	**
E1100	E1100	2296	W/C SEMI-RECLINING (E1100), SWING AWAY DETACH ELEV LEG RESTS	**	**
E1110	E1110	2295	W/C SEMI-RECLINING (E1110), DETACH ARMS ELEV LEG REST	**	**
E1130	E1130	2303	W/C STANDARD (E1130), FIX OR SWING AWAY DETACH FOOTRESTS	**	**
E1140	E1140	2313	W/C (E1140), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1150	E1150	2314	W/C (E1150), DETACH ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2315	W/C (E1160), W/ FIX ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2396	W/C (E1160), W/FIX ARMS REMOVABLE FOOTRESTS	**	**
E1170	E1170	2241	W/C AMPUTEE (E1170), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1171	E1171	2242	W/C AMPUTEE (E1171), FIX ARMS, W/OUT FOOTRESTS OR LEGREST	**	**
E1172	E1172	2240	W/C AMPUTEE (E1172), DETACH ARMS W/OUT FOOTRESTS OR LEGREST	**	**
E1180	E1180	2239	W/C AMPUTEE (E1180), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1190	E1190	2238	W/C AMPUTEE (E1190), DETACH ARMS SWING AWAY DETACH ELEV LEGRESTS	**	**
E1195	E1195	2273	W/C HVY DUTY (E1195), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1200	E1200	2243	W/C AMPUTEE (E1200), FIX FULL LENGTH ARMS, S/AWAY  D/FOOTREST	**	**
E1210	E1210	2281	W/C MOTORIZED (E1210), FIX ARMS, S/AWAY DETACH ELEV LEG RESTS	COST+10%	**
E1211	E1211	2279	W/C MOTORIZED (E1211), DETACH ARMS , S/AWAY DETACH FOOT RESTS	COST+10%	**
E1212	E1212	2282	W/C MOTORIZED (E1212) , FIX ARMS, SWING AWAY DETACH FOOT RESTS	COST+10%	**
E1213	E1213	2280	W/C MOTORIZED (E1213), DETACH ARMS S/AWAY, DETACH ELEV LEG REST	COST+10%	**
E1220	E1220	2551	W/C CUSTOM (E1220)	COST+10%
E1220	E1220	2579	W/C XXWIDE (E1220)			COST+10%
E1230	E1230	2288	SCOOTER (E1230), THREE OR 4 WHEEL	**	**
E1240	E1240	2276	W/C LT-WGT (E1240), DETACH ARMS SWING AWAY DETACH, ELEV LEGREST	**	**
E1250	E1250	2278	W/C LT-WGT (E1250), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1260	E1260	2275	W/C LT-WGT (E1260), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1270	E1270	2277	W/C LT-WGT (E1270), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1280	E1280	2270	W/C HVY DUTY (E1280), DETACH ARMS ELEV LEGRESTS	**	**
E1285	E1285	2274	W/C HVY DUTY (E1285), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1290	E1290	2271	W/C HVY DUTY (E1290), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1295	E1295	2272	W/C HVY DUTY (E1295), FIX ARMS, ELEV LEGREST	**	**
E1300	DM570	2062	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	**
E1310	DM570	2061	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	COST+10%
E1353	E1353	2381	O2 REGULATOR (E1353)	**	**
E1355	E1355	2384	CYLINDER STAND/RACK (E1355)	**
E1372	E1372	2331	IMMERSION EXT HEATER (E1372) FOR NEBULIZER	**	**
E1375	E1375	2334	NEBULIZER PORT (E1375) W/ SMALL COMPRESSOR, W/ LIMITED FLOW	**
E1399	DM570	2568	ADAPTER (A9900), AC/DC	**
E1399	E1399	2586	APNEA MONITOR DOWNLOAD (E1399)			**
E1399	DM570	2552	BATH LIFT (E1399), CUSTOM	COST+10%
E1399	DM570	2563	BED WEDGE (E1399), 12"	**
E1399	DM570	2856	BEDROOM EQUIPMENT (E1399), CUSTOM	COST+10%
E1399	E1399	2525	BREAST PUMP, ELECTRIC (E1399)	**	**
E1399	DM570	2581	BREAST PUMP, INSTITUTIONAL (E1399)	**
E1399	E1399	2580	BREAST PUMP, MANUAL (E1399)	**
E1399	DM570	2593	COLD THERAPY UNIT, PAD (E1399)	**
E1399	E1399	2565	COMMODE (E1399), DROP ARM, HEAVY DUTY	**
E1399	E1399	2582	COMPRESSION PUMP BOOT (E1399)	**
E1399	E1399	2583	COMPRESSION PUMP, FOOT (E1399)		**
E1399	A9900	2569	CPAP HUMIDIFIER (A9900), HEATED	**	**
E1399	A9900	2635	CPAP/BIPAP SUPPLIES (A9900)	COST+10%
E1399	E1399	2327	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	COST+10%
E1399	E1220	2584	XXXX CHAIR (E1399), THREE POSITION RECLINING		**
E1399	DM570	6780	XXXXXX MONITOR (G0004)		**
E1399	E0265	2590	HOSP BED (E1399), ELECTRIC, XLONG, W/MATTRESS & SIDE RAILS	**	**
E1399	E0200	2868	LAMP, ULTRAVIOLET (E1399)	**
E1399	DM570	2588	MONITOR (E1399), XXXXX XXXXX		**
E1399	DM570	2529	O2 ANALYZER (A9900)	**	**
E1399	A9900	2594	O2 CONSERVATION DEVICE (A9900)	**	**
E1399	DM570	6775	OXIMETRY TEST (E1399)			**
E1399	DM570	2555	PATIENT LIFT, CUSTOM (E1399)	COST+10%
E1399	DM570	2561	PEAK FLOW METER (E1399)	**
E1399	E1399	4559	PEDIATRIC XXXXXX (E1399)	COST+10%
E1399	DM570	2567	PNEUMOGRAM (E1399)	**
E1399	E1399	2553	POSITIONING, CUSTOM (E1399)	COST+10%
E1399	E1399	2526	PULSE OXIMETER (E1399)	**	**
E1399	E1399	2527	PULSE OXIMETER W/ PROBE (E1399)	**	**
E1399	DM570	2562	SHOWER, HAND HELD (E1399)	**
E1399	DM570	2592	SLEEP STUDY, ADULT (E1399)	**
E1399	DM590	7483	STIMULATOR (E1399), MUSCLE, LOW VOLTAGE OR INTERFERENTIAL	COST+10%	COST+10%
E1399	DM570	2855	THERAPY EQUIPMENT, CUSTOM (E1399)	COST+10%
E1399	DM570	6774	THERAPY PERCUSSION, GENERATOR ONLY	**	**
E1399	E1399	7506	W/C, CUSTOM (E1399) MANUAL ADULT	COST+10%
E1399	E1399	7504	W/C, CUSTOM (E1399) MANUAL PEDIATRIC	COST+10%
E1399	E1399	7507	W/C, CUSTOM (E1399) POWER ADULT	COST+10%
E1399	E1399	7505	W/C, CUSTOM (E1399) POWER PEDIATRIC	COST+10%
E1399	E1399	2564	XXXXXX (E1399), HEAVY DUTY, EXTRA WIDE	**
E1399	E1399	2585	XXXXXX (E1399), HEMI	**
E1399	DM570	6873	WOUND SUCTION DEVICE (K0538)			COST+10%
E1400	E1390	2361	O2 CONC (E1390),MANUF SPEC MAXFLOWRATE = 2 LTS PER MIN@85%	**	**
G0015	DM570	6779	CARDIAC EVENT MONITOR (G0015)		**
K0163	DM590	3713	ERECTION SYSTEM, VACUUM (K0163)	**
K0183	DM590	2516	CPAP MASK (K0183)	**
K0184	DM590	2515	NASAL PILLOWS/SEALS (K0184) REPLACEMENT FOR NASAL APP/ DVC, PAIR	**
K0185	DM590	2514	CPAP HEADGEAR (K0185)	**
K0186	DM590	2513	CPAP CHIN STRAP (K0186)	**
K0187	DM590	2512	CPAP TUBING (K0187)	**
K0188	DM590	2511	CPAP FILTER (A9900), DISPOSABLE	**
K0189	DM590	2510	CPAP FILTER (A9900), NON-DISPOSABLE	**
K0268	DM590	2509	CPAP HUMIDIFIER (K0268), COOL	**
K0413	DM590	6889	MATTRESS (K0413), NONPOWERED, EQUIVALENT		**
E1399	E1399	7673	MATTRESS (E1399) V-CUE DYNAMIC AIR THERAPY			COST+10%
A4608	A9900	7621	CATHETER TRACH (A4608) 11CM 1 SCOOP	**
E1399	A9900	7664	COFFLATOR (E1399CF) MANUAL SECRETION MOBIL DEVICE		**
E0168B	A9900	7643	COMMODE (E0168B) HVY DUTY BEDSIDE CHAIR 000-000 XXX.	**
E0168C	A9900	7644	COMMODE (E0168C) HVY DUTY DROP ARM 451-850 LBS.	**
A6234	HH591	7626	DRESSING <16 SQ IN (A6234) HYDROCOLLOID DRESSING, EA	**
A6258	HH591	7627	DRESSING >16 SQ IN (A6258) TRANSPAREN FILM, EA	**
A46203	HH591	7625	DRESSING COMPOSITE <16 SQ IN (A46203) SELF ADH, EA	**
B9998B	DM590	7655	ENT (B9998B) EXT SET Y SITE F/KANGAROO PUMP	**
B9998C	DM590	7656	ENT (B9998C) EXT SET W/ CLAMP BASIC	**
B9998D	DM590	7657	ENT (B9998D) XXXXXXX GASTRIC RELIEF VLV	**
B9998E	DM590	7658	ENT (B9998E) GASTRO EXT SET	**
B9998F	DM590	7659	ENT (B9998F) GASTRO TUBE ANY SIZE MIC-KEY OR HIDE A PORT	**
E1399	A9900	7620	HUMID-VENT (E1399) ARTIFICIAL NOSE	**
E1399	A9900	0000	XXXX (E1399) UNIV SET UP W/MANIFOLD NEBULIZER	**
K0105	A9900	7639	IV POLE (K0105) ATTACH F/ W/C	**
E1399	A9900	7641	MECHANICAL SCALE (E1399) PEDIATRIC/NEONATAL	**
A7008	A9900	7661	NEBULIZER (A7008) KIT PREFILL W/STR H20 1L BAX	**
E1399	A9900	7663	O2 CONNECTOR (E1399) XXXX/IRRIGATION NOZZLE BAX	**
E1399	A9900	7615	O2 HUMIDIFIER (E1399) AQUA+NEONATAL EA HUD	**
E1399	A9900	7623	O2 SWIVEL (E1399) ADAPTER ANGLED STERILE	**
L8501	A9900	7624	SPEAKING VALVE (L8501) WHITE PAS	**
A4319	HH591	7629	STERILE WATER (A4319) F/IRRIG 1L BAX	**
A7001	HH591	7619	SUCTION BOTTLE (A7001) W/LID & TUBING	**
E1399	A9900	7616	SUCTION FILTER (E1399) BACTERIA	**
A6265	HH591	7628	TAPE ALL TYPES (A6265) EXCLUDING MICROFOAM, PER 18 SQ INCHES	**
A4481	A9900	7622	TRACH FILTER (A4481) BACTERIA ELECTROSTATIC	**
A4623	A9900	7618	TRACH INNER (A4623) CANNULA	**
A4621	A9900	7617	TRACH TUBE MASK (A4621) COLLAR OR HOLDER	**
A7010	A9900	7662	TUBING (A7010) AEROSOL CORRUGATED PER FOOT	**
E1399	A9900	7631	VENT ADAPTER (E1399) MDI HUD	**
A9900	A9900	7630	VENT BATTERY CHARGER (A9900) 12V GEL	**
E1399	A9900	7632	VENT CONNECTOR (E1399) PED OR ADULT OMNIFLEX DISP	**
E1399	A9900	7633	VENT FILTER (E1399) HYGROBAC S ELECTOSTATIC MAL	**
E1399	A9900	7634	VENT THERMOMETER (E1399) W/ ADAPTER	**
K0108	A9900	7638	W/C BRAKE EXTENSION (K0108) TIP BLK 10/PK	**
E1399	A9900	7635	XXXXXX BASKET (E1399) VINYL COATED	**
E0159	A9900	7640	XXXXXX BRAKE (E0159) ATTACHMENT	**
E0148	A9900	7636	XXXXXX HVY DUTY (E0148) FOLDING X-WIDE	**
E0149	A9900	7637	XXXXXX HVY DUTY (E0149) W/ WHEELS	**
E1399	A9900	7645	CPAP (E1399) DC BATTERY ADAPTER CABLE	**
E1399	A9900	7646	CPAP (E1399) EXHALATION PORT DISP	**
E1399	A9900	7647	CPAP (E1399) FUSE KIT INTERNATIONAL A/C	**
E1399	A9900	7648	CPAP (E1399) HUMIDIFIER CHAMBER KIT DISP	**
E1399	A9900	7649	CPAP (E1399) HUMIDIFIER CHAMBER REUSABLE	**
E1399	A9900	7650	CPAP (E1399) HUMIDIFIER MOUNTING TRAY	**
E1399	A9900	7651	CPAP (E1399) INVERTOR AC/DC	**
E1399	A9900	7652	CPAP (E1399) POWER CORD F/ARIA-SYNC	**
E1399	A9900	7653	CPAP (E1399) SHELL W/O PRESSURE TAP	**
A9900	DM590	7566	CPAP CALIBRATION SHELL (A9900)	**
A9900	DM590	7565	CPAP SHORT TUBING (A9900)	**
E0601	E0601	7690	VENT, CONTINUOUS POSITIVE (E0500) AIRWAY PRESSURE DEVICE	N/A	**
E0452	E0452	7691	VENT, BILEVEL INTERMITTENT (E0500) ASSIST DEVICE (BIPAP)	N/A	**

The following items were added in 2002:
E0747	DM570	6875	STIMULATOR, OSTEOGENIC, ULTRASOUND	**
A9900	A9900	7695	GEL/SILICON GOLD SEAL CPAP/BIPAP MASK (A9900)	**
A9900	A9900	7701	VENT THERAPEUTIC ST BIPAP W/ BACKUP RATE (K0533)	N/A	**
A9900	A9900	7703	O2 SYS HELIOS PORT LIQUID, RENT (E1399)		COST+10%
HH591	HH591	7704	PUMP, EXT INFUSION, XXXX DIABECARE, INSULIN (E0784)	COST+10%
E0784	E0784	7731	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	**
A9900	A9900	7737	CPAP DREAM SEAL INTERFACE FOR USE WITH BREEZE MASK (A9900)	COST+10%
DM590	DM590	7738	CPAP CHIN STRAP DELUXE (K0186)	COST+10%
E1340	E1340	7768	W/C REPAIRS - CUSTOM (E1340)	COST+10%

The following may be charged under extraordinary circumstances:
E1399	E1399	4551	LABOR/SERVICE/SHIPPING CHARGES	COST+10%
E1399	E1399	2731	SHIPPING AND HANDLING FEES	COST+10%

The following may be charged if over and above routine on rental equipment:
E1350	E1350	2382	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	COST+10%
E1340	E1340	2554	W/C REPAIRS - STANDARD (E1340)	COST+10%
E1399	E1399	4552	MISCELLANEOUS SUPPLIES	COST+10%		COST+10%
E1399	E1399	2589	REPAIR (E1399), RESPIRATORY EQUIPMENT	COST+10%
E1399	E1399	4561	RESPIRATORY SUPPLIES (A4618)	COST+10%		COST+10%
E1399	E1399	4549	TENS/APNEA SUPPLIES	COST+10%		COST+10%

NOTES:

1.  Whether rental or purchase, rates include all shipping, labor and set-up.

2.   If item is rented, rates include all supplies to enable the equipment to function effectively, with the exception of supplies for CPAP, BIPAP, Ventilators, Suction, Enteral Pumps and CPM.  Such exception supplies will be billed at cost plus 10%.

3.   If item is rented, rates include repair and maintenance costs.

4.   If item is purchased, supplies, repair and maintenance will be billed at cost plus 10%.

5.   All equipment not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   Rates effective through 12/31/2003.

** Confidential Treatment Requested

Gentiva Health Network
EXHIBIT B1:  TRADITIONAL HOME HEALTH PPO FEE-FOR-SERVICE SCHEDULE
Effective January 1, 2003

The following Traditional Home Health Services have both Visit and Hourly rates.
Notes 1, 2, 3, 4, 5 and 6 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
CERTIFIED NURSES AIDE	**	**	**	**	**	**
HOME HEALTH  AIDE	**	**	**	**	**	**
LVN/LPN	**	**	**	**	**	**
LVN/LPN - HIGH TECH	**	**	**	**	**	**
PEDIATRIC HIGH TECH LVN/LPN	**	**	**	**	**	**
PEDIATRIC HIGH TECH RN	**	**	**	**	**	**
PEDIATRIC LVN/LPN	**	**	**	**	**	**
PEDIATRIC RN	**	**	**	**	**	**
RN	**	**	**	**	**	**
RN HIGH TECH  INFUSION	**	**	**	**	**	**
RN HIGH TECH OTHER	**	**	**	**	**	**

The following Traditional Home Health Services have Visit only rates.
Notes 1, 3, 4, 5, 7 and 8 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
DIABETIC NURSE	**	N/A	**	N/A	**	N/A
DIETITIAN	**	N/A	**	N/A	**	N/A
ENTEROSTOMAL THERAPIST	**	N/A	**	N/A	**	N/A
MATERNAL CHILD HEALTH	**	N/A	**	N/A	**	N/A
MEDICAL SOCIAL WORKER	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PHLEBOTOMIST	**	N/A	**	N/A	**	N/A
PHOTOTHERAPY PACKAGE SERVICE	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PSYCHIATRIC NURSE	**	N/A	**	N/A	**	N/A
REHABILITATION NURSE	**	N/A	**	N/A	**	N/A
RESPIRATORY THERAPIST	**	N/A	**	N/A	**	N/A
RN ASSESSMENT, INITIAL	**	N/A	**	N/A	**	N/A
RN SKILLED NURSING ADMISSION VISIT	X/X	X/X	X/X	X/X	X/X	X/X
RN SKILLED NURSING VISIT-EXTENSIVE	**	N/A	**	N/A	**	N/A
SPEECH THERAPIST	**	N/A	**	N/A	**	N/A

The following Traditional Home Health Service has Hourly only rates.
Notes 3, 4 and 5 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
HOMEMAKER	N/A	**	N/A	**	N/A	**

The following Traditional Home Health Service is priced on a Per Diem basis.
Notes 3, 4 and 5 apply	Xxxx 0		Xxxx 0		Xxxx 0
		Per Diem		Per Diem		Per Diem
COMPANION/LIVE IN		**		**		**

** Confidential Treatment Requested

NOTES:

1.   Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration).

2.   Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3.

3.   CIGNA does not reimburse for travel time, weekend, holiday or evening differentials.

4.   Above prices have no exclusions.

5.   All services not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT.

7.   Respiratory Therapist visit utilization/costs to be reported with HME/RT.

8.   Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment.  Use requires special coordination.

** Confidential Treatment Requested

EXHIBIT B2 HOME INFUSION THERAPY PPO FEE-FOR-SERVICE SCHEDULE
Effective January 1, 2003

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem	Primary or Multiple Therapy Dispensing Fee	Primary or Multiple Therapy Drug Discount off AWP
Ancillary Drugs		**	-15%
Biological Response Modifiers		**	-13%
Cardiac (Inotropic) Therapy	**		-15%
Chelation Therapy	**		-15%
Chemotherapy	**		-15%
Enteral Therapy	**		N/A
Enzyme Therapy	**		0%
Growth Hormone		**	-13%
IV Immune Globulin	**		0%
Other Injectable Therapies		**	-13%
Other Infusion Therapies	**		-15%
Pain Management Therapy	**		-15%
Steroid Therapy	**		-15%
Thrombolytic (Anticoagulation) Therapy	**		-15%
Synagis		**	-13%
Remodulin Therapy	**		-3%

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple anti-infective therapies
	Per Diem		Drug Discount Off AWP
Anti-Infectives - Primary Anti-Infective	**		-15%
Anti-Infectives - Multiple Anti-Infective	**		-15%

style="font-family: Arial; font-weight: bold" The following Home Infusion Therapy service rate EXCLUDES drugs.  Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective therapies
	Primary or Multiple Therapy Per Diem		Cost of Drug
Flolan Therapy	**
Flolan 0.5 mg vial			AWP
Flolan 1.5 mg vial			AWP
Flolan diluent vial			AWP

The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem
Enteral Therapy	**
Hydration Therapy	**
Total Parenteral Nutrition	**

** Confidential Treatment Requested

EXHIBIT B2 HOME INFUSION THERAPY PPO FEE-FOR-SERVICE SCHEDULE
 

NOTES:

1.  Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.
 

2.   Per Diems INCLUDING drugs include ALL costs - including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.   
 

3.   "DISPENSING FEE" is defined as per each time the drug is dispensed by the home infusion provider.
 

4.   "PER DIEM" costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES.
 

5.   The per diem rate shall only be charged for those days the Participant receives medication.
 

6.   For home infusion pharmaceuticals not listed on fee schedule, AWP less 15% will apply.
 

7.   Case Managers should utilize Enteral Therapy WITHOUT drugs as an infusion benefit infrequently.  Generally, patient's requiring Enteral Therapy WITHOUT drugs should have services coordinated through the DME benefit.
 

** Confidential Treatment Requested

The following are for the stated item ONLY.  Unless otherwise noted, nursing, supplies, etc. are NOT included.
Blood Transfusion per Unit (Tubing, Filters)			**
Catheter Care Per Diem			**
Midline Insertion (Catheter & Supplies)			**
PICC Line Insertion (Catheter & Supplies)			**
Blood Product			COST PLUS 10%

** Confidential Treatment Requested

EXHIBIT B2 HOME INFUSION THERAPY PPO FEE-FOR-SERVICE SCHEDULE
 

Factor Concentrates
		Vial price	Unit Price
Factor VII
Novoseven 1200MCG Vial
Novoseven 4800MCG Vial		**
Novoseven in 1200MCG or 4800MCG QTY			**
Factor VIII (Recombinant)
Recombinate			**
Kogenate or Helixate			**
Bioclate			N/A
Helixate FS			**
Kogenate FS			**
Refacto			**
Factor VIII (Monoclonal)
Hemofil-M or A. R. C. Method M			**
Monoclate P			**
Monarc-M			**
Factor VIII (Other)
Koate			**
Humate			**
Alphanate SDHT			**
Factor IX (Recombinant)
BeneFix			**
Factor IX (Monoclonal/High Purity)
Mononine			**
Alphanine			**
Factor IX (Other)
Konyne - 80			N/A
Proplex T			**
Bebulin			**
Profilnine SD			**
Anti-Inhibitor Complex
Autoplex-T			**
Feiba-VH			**
Hyate-C			**
HEMOSTATIC AGENTS
DDAVP - 10ml vial			AWP - 10%
Stimate  - 2.5xx xxxx			AWP - 10%
Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support; home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation

** Confidential Treatment Requested

GENTIVA HEALTH SERVICES CARECENTRIX EXHIBIT B3:  HOME MEDICAL EQUIPMENT/RESPIRATORY THERAPY PPO FEE-FOR-SERVICE SCHEDULE EFFECTIVE DATE:  JANUARY 1, 2003
HCPCS CODE	CHC CODE	GENTIVA CODE	DESCRIPTION	PURCHASE PRICE	RENTAL PRICE	DAILY PRICE
A4660	DM590	2520	MONITOR, BLOOD PRESSURE (A4660) W/STETH & CUFF	**
A4670	DM590	2518	MONITOR, BLOOD PRESSURE (A4670) , AUTOMATIC	**
A9900	A9900	7552	BREEZE (A9900) CPAP/BIPAP MASK	**
A9900	A9900	7553	FULL FACE (A9900) MIRAGE CPAP/BIPAP MASK	**
A9900	A9900	7554	GEL/SILICON (A9900) CPAP/BIPAP MASK INCL GLD SEAL,PHANTM,MONARCH	**
A9900	A9900	7556	SPECIALTY (A9900) CPAP/BIPAP MASK (PROFILE OR SIMPICITY)	**
DM590	HI531	2570	PUMP, ENTERAL (B9002)	**	**
B9998	DM590	6828	ENTERAL SUPPLIES (B9998)			COST+10%
DM590	DM570	7551	BACK-PACK (E1399),  FOR PORTABLE ENTERAL PUMP	**
DM590	DM590	2522	CANNULA, NASAL	COST+10%
DM590	DM590	7509	ENTERAL PUMP, PORTABLE (B9002)	COST+10%	COST+10%
DM590	DM590	7508	MASK, CPAP GEL OR SILICONE (K0183)	COST+10%
E0100	E0100	2020	CANE (E0100), ADJ OR FIX, W/ TIP	**
E0105	E0105	2021	CANE, QUAD (E0105)  OR THREE PRONG, ADJ OR FIX, W/ TIPS	**
E0110	E0110	2028	CRUTCHES, FOREARM (E0110),  ADJ OR FIX, PAIR, W/ TIPS, GRIPS	**
E0111	E0111	2023	CRUTCH FOREARM (E0111),  ADJ OR FIX, EACH, W/ TIP AND GRIPS	**
E0112	E0112	2027	CRUTCHES UNDERARM,  WOOD (E0112), ADJ OR FIX, PAIR, COMPLETE	**
E0113	E0113	2025	CRUTCH UNDERARM, WOOD (E0113),  ADJ OR FIX, EACH, COMPLETE	**
E0114	E0114	2026	CRUTCHES UNDERARM, ALUM (E0114),  ADJ OR FIX, PAIR, COMPLETE	**
E0116	E0116	2024	CRUTCH UNDERARM, ALUM (E0116),  ADJ OR FIX, EACH, COMPLETE	**
E0130	E0130	2037	XXXXXX, RIGID (E0130)  (PICKUP), ADJ OR FIX HEIGHT	**
E0135	E0135	2036	XXXXXX, FOLDING (E0135)  (PICKUP),  ADJ OR FIX HEIGHT	**
E0141	E0141	2040	XXXXXX, WHEELED (E0141),  W/OUT SEAT	**
E0142	DM570	2034	RIGID XXXXXX (E0142), WHEELED, W/ SEAT,	**
E0143	E0143	2029	XXXXXX FOLDING, WHEELED (E0143), W/OUT SEAT	**
E0145	DM570	2039	XXXXXX (E0145), WHEELED, W/ SEAT AND CRUTCH ATTACHMENTS	**
E0146	DM570	2038	XXXXXX, WHEELED, W/ SEAT (E0146)	**
E0147	E0147	2030	XXXXXX HVY DUT (E0147),  MULT BRAKING SYS, VAR WHEEL RESISTANCE	**
E0153	E0153	2032	CRUTCH PLATFORM ATTACHMENT (E0153), FOREARM EA	**
E0154	E0154	2033	XXXXXX PLATFORM ATTACHMENT (E0154), EA	**
E0155	E0155	2041	XXXXXX WHEEL ATTACHMENT (E0155), RIGID (PICKUP) XXXXXX	**
E0156	DM570	2035	XXXXXX SEAT ATTACHMENT (E0156)	**
E0157	E0157	2022	XXXXXX, CRUTCH ATTACHMENT (E0157), EACH	**
E0158	E0158	2031	XXXXXX LEG EXTENSIONS (E0158)	**
E0163	E0163	2047	COMMODE CHAIR, STATIONARY  (E0163),  W/ FIX ARMS	**
E0164	E0164	2045	COMMODE CHAIR, MOBILE  (E0164),  W/ FIX ARMS	**
E0165	E0165	2046	COMMODE CHAIR (E0165), STATIONARY, W/ DETACH ARMS	**
E0165	E0165	2591	COMMODE, XXWIDE(E0165)	**
E0166	E0166	2044	COMMODE CHAIR (E0166), MOBILE, W/ DETACH ARMS	**
E0167	E0167	2051	COMMODE CHAIR, PAIL OR PAN (E0167)	**
E0176	E0176	2142	CUSHION (E0176) OR AIR PRESSURE PAD, NON-POSITIONING	**
E0176	E0176	2394	REPLACEMENT PAD (E0176) ALTERNATING PRESS	**
E0177	E0177	2224	CUSHION OR WATER PRESS PAD (E0177), NONPOSITIONING	**
E0178	E0178	2160	CUSHION OR GEL PRESS PAD (E0178), NONPOSITIONING	**
E0179	E0179	2154	CUSHION (E0179) OR DRY PRESSURE PAD, NONPOSTIONING	**
E0180	E0180	2196	PUMP (E0180), ALTERNATING PRESSURES W/PAD	**	**
E0181	E0181	2197	PUMP (E0181), ALTERNATING PRESS W/PAD,  HVY DUTY	**	**
E0184	E0184	2074	MATTRESS, DRY PRESSURE (E0184)	**
E0185	E0185	2076	MATTRESS (E0185), GEL OR GEL-LIKE PRESSURE PAD	**
E0186	E0186	2064	MATTRESS, AIR PRESSURE (E0186)	**
E0187	E0187	2099	MATTRESS, WATER PRESSURE (E0187)	**
E0188	DM570	2217	PAD, SYNTHETIC SHEEPSKIN (A9900)	**
E0189	DM570	2177	PAD, LAMBSWOOL SHEEPSKIN (E0189), ANY SIZE	COST+10%
E0192	E0192	2573	CUSHION, XXX FOR W/C (E0192)	**	**
E0192	E0192	2572	CUSHION, ROHO FOR W/C  (E0192)	**	**
E0192	E0192	2178	W/C PAD (E0192), LOW PRESS AND POSITIONING EQUALIZATION	**	**
E0193	E0193	2098	MATTRESS, LOW AIR LOSS (E0193), INCL. BED	**	**	**
E0194	DM570	2063	AIR FLUIDIZED BED (E0194)		**	**
E0196	E0196	2077	MATTRESS, GEL PRESSURE (E0196)	**
E0197	E0197	2065	MATTRESS, AIR PRESSURE PAD (E0197)	**
E0198	E0198	2100	MATTRESS (E0198), WATER PRESSURE PAD	**
E0199	E0199	2075	MATTRESS, DRY PRESSURE PAD (E0199)	**
E0200	E0200	2228	HEAT LAMP (E0200),  W/OUT STAND, INCL/BULB, OR INFRARED ELEMENT	**
E0202	E0202	2229	PHOTOTHERAPY (BILIRUBIN) (E0202), LIGHT WIT			**
E0202	E0202	2524	PHOTOTHERAPY, BILI BLANKET (E0202)			**
E0205	E0205	2227	HEAT LAMP (E0205), WITH STAND, INCL/ BULB, OR INFRARED ELEMENT	**
E0210	DM570	2156	HEATING PAD, STANDARD (E0210)	**
E0215	DM570	2155	HEATING PAD (E0215), ELECTRIC, MOIST	**
E0218	DM570	2560	COLD THERAPY UNIT (E0218)	**	**	**
E0235	DM570	2187	PARAFFIN BATH UNIT, PORT (E0235)	**
E0236	DM570	2199	PUMP (E0236) FOR WATER CIRCULATING PAD	**
E0237	DM570	2223	HEAT COLD WATER (E0237) CIRCULATING PAD W/PUMP	**
E0238	DM570	2179	HEATING PAD (E0238), MOIST, NON-ELECTRIC	**
E0241	DM570	2867	BATH TUB RAIL (E0241), WALL, L-SHAPE	**
E0241	DM570	2862	BATH TUB RAIL, WALL, 12" (E0241)	**
E0241	DM570	2863	BATH TUB RAIL, WALL, 16" (E0241)	**
E0241	DM570	2864	BATH TUB RAIL, WALL, 18" (E0241)	**
E0241	DM570	2865	BATH TUB RAIL, WALL, 24" (E0241)	**
E0241	DM570	2866	BATH TUB RAIL, WALL, 36" (E0241)	**
E0241	DM570	2043	BATH TUB RAIL, WALL, UNSPECIFIED SIZE	COST+10%
E0242	DM570	2042	BATH TUB RAIL, FLOOR BASE (E0242)	**
E0243	DM570	2056	TOILET RAIL, EACH (E0243)	**
E0244	E0244	2587	TOILET SEAT (E0244) RAISED WITH ARMS	**
E0244	E0244	2052	TOILET SEAT, RAISED (E0244)	**
E0245	DM570	2575	BATH BENCH WITH BACK (E0245)	**
E0245	DM570	2058	BATH TUB STOOL OR BENCH (E0245)	**
E0245	DM570	2578	TRANSFER BENCH, NON-PADDED (E0245)	**
E0245	DM570	2577	TRANSFER BENCH, PADDED (E0245)	**
E0246	DM570	2057	TRANSFER TUB RAIL(E0246), ATTACHMENT	**
E0249	DM570	2186	HEAT UNIT (E0249), WATER CIRCULATING PAD	**
E0255	E0255	2090	HOSP BED (E0255), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/ MATTRESS	**	**
E0256	E0256	2091	HOSP BED (E0256), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/O MATTRESS	**	**
E0260	E0260	2083	HOSP BED (E0260), SEMI-ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0261	E0261	2084	HOSP BED (E0261), SEMI-ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0265	E0265	2086	HOSP BED (E0265), TOTAL ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0266	E0266	2087	HOSP BED (E0266), TOTAL ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0271	E0271	2096	MATTRESS, INNERSPRING (E0271)	**
E0272	E0272	2095	MATTRESS, FOAM RUBBER (E0272)	**
E0273	DM570	2068	BED BOARD (E1399)	**
E0274	DM570	2097	OVER-BED TABLE (E0274)	**
E0275	E0275	2071	BED PAN, STANDARD (E0275), METAL OR PLASTIC	**
E0276	E0276	2070	BED PAN, FRACTURE (E0276), METAL OR PLASTIC	**
E0277	E0277	2066	MATTRESS (E0277), LOW AIR LOSS, ALT PRESSURE	**	**
E0280	DM570	2069	BED CRADLE, ANY TYPE (E1399)	**
E0292	E0292	2092	HOSP BED (E0292), VAR HEIGHT, HI-LO, W/OUT S/ RAILS, W/ MATTRESS	**	**
E0293	E0293	2093	HOSP BED (E0293), VAR HEIGHT, HI-LO,  NO SIDE RAILS, NO MATTRESS	**	**
E0294	E0294	2085	HOSP BED (E0294), SEMI-ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0295	E0295	2094	HOSP BED (E0295), SEMI-ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0296	E0296	2089	HOSP BED (E0296), TOTAL ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0297	E0297	2088	HOSP BED (E0297), TOTAL ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0305	E0305	2073	BED SIDE RAILS (E0305), HALF LENGTH	**
E0310	E0310	2072	BED SIDE RAILS (E0310), FULL LENGTH	**
E0315	DM570	2067	BED ACCESSORIES: BOARDS OR TABLES, ANY TYPE	COST+10%
E0325	E0325	2060	URINAL; MALE (E0325), JUG-TYPE, ANY MATERIAL	**
E0326	E0326	2059	URINAL; FEMALE (E0326), JUG-TYPE, ANY MATERIAL	**
E0372	E0372	7008	MATTRESS (E0372) POWERED AIR OVERLAY		**	**
E0410	E0444	2369	O2 CONTENTS, LIQUID (E0444), PER POUND	**
E0416	E0443	2371	O2 REFILL FOR PORT (E0443) GAS SYSTEM ONLY, UP TO 23 CUBIC FEET	**
E0424	E0424	2385	O2 SYS STATIONARY (E0424) COMPR GAS, RENT		**
E0430	E0430	2374	O2 SYS PORT GAS, PURCH (E0430)	**
E0431	E0431	2574	O2 SYS PORT GAS, LIGHTWEIGHT (E0431) W/CONSERV DEVICE,NO CONTENT	**	**
E0431	E0431	2375	O2 SYS PORT GAS, RENT (E0431)		**
E0434	E0434	2377	O2 SYS PORT LIQUID,RENT (E0434)		**
E0435	E0435	2376	O2 SYS PORT LIQUID, PURCH (E0435)	**
E0439	E0439	2388	O2 SYS STATIONARY (E0439) LIQUID, RENT		**
E0440	E0440	2387	O2 SYS STATIONARY (E0440) LIQUID, PURCH	**
E0443	E0400	2869	O2 CONTENTS, H/K CYLINDER (E0400), 200-300 CUBIC FT	**
E0444	E0444	2379	O2 CONTENTS, PORT LIQUID (E0444), PER UNIT (1 UNIT = 1 LB.)	**
E0450	E0450	7555	POSITIVE PRESSURE VENTS (E0450)(E.G. T-BIRD)		**
E0450	E0450	2392	VENTILATOR VOLUME (E0450), STATIONARY OR PORT	**	**
E0450	E0450	7522	VENTILATOR, VOLUME, (E0450) EMERGENCY BACKUP UNIT	COST+10%	**
E0452	E0452	2332	BILEVEL INTERMITTENT (E0452) ASSIST DEVICE,(BIPAP)	**	**
E0453	E0453	2390	VENTILATOR THERAPEUTIC (E0453); FOR USE 12 HOURS OR LESS PER DAY	**	**
E0455	E0455	2372	O2 TENT (E0455), EXCLUDING CROUP OR PEDIATRIC TENTS	**	**
E0457	E0457	2323	CHEST SHELL (CUIRASS) (E0457)	**	**
E0459	E0459	2324	CHEST WRAP (E0459)	**	**
E0460	E0460	2339	VENTILATOR (E0460), NEGATIVE PRESSURE , PORTABLE OR STATIONARY	**	**
E0480	DM570	2373	PERCUSSOR (E0480), ELEC OR PNEUM, HOME MODEL	**	**
E0500	E0500	0000	XXXX , W/ BUILT-IN NEB (E0500) MAN OR AUTO VALVES; INT/EXT POWER	**	**
E0550	E0550	2328	HUMIDIFIER (E0550) DURABLE FOR EXTENSIV SUP/ HUMID W/ IPPB OR O2	**	**
E0555	E0555	2330	HUMIDIFIER (E0555), DURABLE, GLASS, FOR USE W/ REG OR FLOWMETER	COST+10%
E0565	E0565	2325	COMPRESSOR, AIR POWER (E0565)	**	**
E0570	E0570	2336	NEBULIZER, W/ COMPRESSOR (E0570)	**
E0575	DM570	2571	NEBULIZER (E0575), ULTRASONIC, AC/DC	**	**
E0575	DM570	2338	NEBULIZER; ULTRASONIC (E0575)	**	**
E0585	E0585	2337	NEBULIZER(E0585), W/ COMPRESSOR AND HEATER	**	**
E0600	E0600	2389	SUCTION PUMP (E0600), HOME MODEL	**	**
E0600	E0600	7523	SUCTION UNIT, (E0600), PORTABLE AC/DC	COST+10%	COST+10%
E0601	E0601	2326	CONTINUOUS POSITVE (E0601) AIRWAY PRESSURE DEVICE (CPAP)	**	**
E0601	E0601	6965	CPAP, SELF TITRATING (E0601)	**	**
E0605	DM570	2391	VAPORIZER, ROOM TYPE (E0605)	**
E0606	DM570	2380	POSTURAL DRAINAGE BOARD (E0606)	**
E0607	E0607	6874	MONITOR, B/GLUCOSE (E0607) ACCUCHEK AD	**
E0607	E0607	2164	MONITOR, BLOOD GLUCOSE (E0607)	**
E0608	E0608	2322	APNEA MONITOR (E0608)	**	**
E0608	E0608	2576	APNEA MONITOR (E0608) W/MEM (INCL SMART)	**	**
E0609	E0609	2146	MONITOR, BLOOD GLUCOSE (E0609) W/SPECIAL FEATURES	**
E0621	E0621	2215	PATIENT LIFT (E0621), SLING OR SEAT, CANVAS OR NYLON	**
E0625	DM570	2191	PATIENT LIFT (E0625), KARTOP, BATHROOM OR TOILET	COST+10%
E0627	E0627	4553	HIP CHAIR (E0627)	**	**
E0627	DM570	2395	SEAT LIFT CHAIR/MOTORIZED (E0627)	**
E0627	DM570	2205	SEAT LIFT MECH (E0627)  INCORPORATED INTO A COMB LIFT-CHAIR MECH	**
E0630	E0630	2190	PATIENT LIFT, HYDRAULIC (E0630), W/ SEAT OR SLING	**	**
E0635	DM570	2189	PATIENT LIFT (E0635), ELEC W/ SEAT OR SLING	**
E0650	E0650	2192	PNEUM COMPRESSOR (E0650), NON-SEG HOME MODEL	**	**
E0651	E0651	2194	PNEUM COMPRESSOR (E0651), SEG HOME MODEL W/OUT CALIB GRAD PRES	**	**
E0652	E0652	2193	PNEUM COMPRESSOR (E0652), SEG HOME MODEL W/ CALIB GRAD PRES	**	**
E0655	E0655	2182	PNEUM COMPRESSOR (E0655), NON-SEG APPLIANCE, HALF ARM	**
E0660	E0660	2181	PNEUM COMPRESSOR (E0660), NON-SEG APPLIANCE, FULL LEG	**
E0665	E0665	2180	PNEUM COMPRESSOR (E0665), NON-SEG APPLIANCE, FULL ARM	**
E0666	E0666	2183	PNEUM COMPRESSOR (E0666), NON-SEG APPLIANCE, HALF LEG	**
E0667	E0667	2210	PNEUM APPLIANCE (E0667), SEG, FULL LEG	**
E0668	E0668	2209	PNEUM APPLIANCE (E0668), SEG, FULL ARM	**
E0669	E0669	2212	PNEUM APPLIANCE (E0669), SEG, HALF LEG	**
E0670	E0670	2211	PNEUM APPLIANCE (E0670), SEG, HALF ARM	**
E0671	E0671	2207	PNEUM APPLIANCE (E0671), SEG GRAD PRESS, FULL LEG	**
E0672	E0672	2206	PNEUM APPLIANCE (E0672), SEG GRAD PRESS, FULL ARM	**
E0673	E0673	2208	PNEUM APPLIANCE (E0673), SEG GRAD PRESS, HALF LEG	**
E0690	DM570	2221	ULTRAVIOLET CABINET (E0690), APPROPRIATE FOR HOME USE	**
E0700	DM570	2204	SAFETY EQUIP (E0700) (E.G., BELT, HARNESS OR VEST)	COST+10%
E0710	DM570	2202	RESTRAINTS (E0710), ANY TYPE (BODY, CHEST, WRIST OR ANKLE)	**
E0720	E0720	2219	TENS (E0720), TWO LEAD, LOCALIZED STIMULATION	**	**
E0730	E0730	2218	TENS (E0730), FOUR LEAD, LARGER AREA/MULTIPLE NERVE STIMULATION	**	**
E0731	E0731	2159	TENS OR NMES (E0731), CONDUCTIVE GARMENT	**
E0744	E0744	2120	STIMULATOR (E0744), NEUROMUSCULAR FOR SCOLIOSIS	**	**
E0745	E0745	2121	STIMULATOR (E0745), NEUROMUSCULAR, ELECTRONIC SHOCK UNIT	**	**
E0745	E0745	6915	STIMULATOR FOUR CH (E0745), NEUROMUSCULAR	**	**
E0746	DM570	2109	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	**	**
E0747	DM570	2122	STIMULATOR (E0747), OSTEOGENIC, NON-INVASIVE	**
E0748	DM570	2124	STIMULATOR (E0748), OSTEOGENIC NON-INVASIVE, SPINAL APPLICATIONS	**
E0755	DM570	2157	STIMULATOR (E0755), ELECTRONIC SALIVARY REFLEX, NON INVASIVE	**
E0776	E0776	2175	IV POLE (E0776)	**	**
E0784	E0784	2158	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	**
E0784	E0784	6771	PUMP (E0784), INSULIN EXT INFUSION DISETRONICS OR OTHER	**
E0840	E0840	2133	TRACTION FRAME (E0840), ATTACH TO HEADBOARD, CERVICAL TRACTION	**
E0850	E0850	2134	TRACTION STAND (E0850), FREE STANDING, CERVICAL TRACTION	**	**
E0855	E0855	7484	TRACTION (E0855), W/O FRAME OR STAND	COST+10%
E0860	E0860	2130	TRACTION EQUIP (E0860), OVERDOOR, CERVICAL	**
E0870	E0870	2131	TRACTION FRAME (E0870), ATTACH TO FOOTBOARD, EXTREMITY, BUCKS	**	**
E0880	E0880	2135	TRACTION STAND (E0880) FREE/STAND EXTREMITY TRACTION, EG, BUCK'S	**	**
E0890	E0890	2132	TRACTION FRAME (E0890), ATTACH TO FOOTBOARD, PELVIC TRACTION	**	**
E0900	E0900	2136	TRACTION STAND (E0900) FREE/ STAND PELVIC TRACTION,( EG, BUCK'S)	**	**
E0910	E0910	2138	TRAPEZE BARS (E0910), A/K/A PT HELPER, ATTACH TO BED W/ GRAB BAR	**	**
E0920	E0920	2111	FRACTURE FRAME (E0920), ATTACH TO BED, INCLUDING WEIGHTS	**	**
E0935	E0935	2125	PASSIVE MOTION (E0935) EXERCISE DEVICE			**
E0935	E0935	2859	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE			**
E0935	E0935	2860	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW			**
E0935	E0935	2857	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND			**
E0935	E0935	2858	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER			**
E0935	E0935	2861	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST			**
E0940	E0940	2137	TRAPEZE BAR (E0940), FREE STANDING, COMPLETE W/ GRAB BAR	**	**
E0941	E0941	2116	TRACTION DEVICE (E0941), GRAVITY ASSISTED	**	**
E0942	E0942	0000	XXXXXXX/XXXXXX (E0942), CERVICAL HEAD	**
E0944	E0944	2126	HARNESS (E0944), PELVIC BELT, BOOT	**
E0945	DM570	2110	HARNESS (E0945), EXTREMITY BELT	**
E0946	E0946	2115	FRACTURE, FRAME (E0946), DUAL W/ CROSS BARS, ATTACH TO BED	**	**
E0947	E0947	2113	FRACTURE FRAME (E0947), ATTACHMENTS FOR COMPLEX PELVIC TRACTION	COST+10%	COST+10%
E0948	E0948	2112	FRACTURE FRAME (E0948) ATTACHMENTS FOR COMPLEX CERVICAL TRACTION	COST+10%	COST+10%
E0950	DM570	2139	TRAY (E0950)	**
E0958	E0958	2307	W/C PART ATTACHMENT (E0958) TO CONVERT ANY W/C TO ONE ARM DRIVE	**
E0959	E0959	2237	W/C PART AMPUTEE ADAPTER(E0959) (COMPENSATE FOR TRANS OF WEIGHT)	**
E0962	E0962	2232	CUSHION FOR WC 1" (E0962)	**
E0963	E0963	2233	CUSHION FOR WC 2" (E0963)	**
E0964	E0964	2234	CUSHION FOR WC 3" (E0964)	**
E0965	E0965	2235	CUSHION FOR WC 4" (E0965)	**
E0972	DM570	2230	TRANSFER BOARD OR DEVICE (E0972)	**
E0977	E0977	2317	CUSHION, WEDGE FOR W/C (E0977)	**
E0978	E0978	2248	BELT, SAFETY (E0978) W/ AIRPLANE BUCKLE, W/C	**
E0979	DM570	2249	BELT, SAFETY (E0979) W/ VELCRO CLOSURE, W/C	**
E0980	DM570	2292	SAFETY VEST (E0980), W/C	**
E1031	E1031	2291	ROLLABOUT CHAIR (E1031), W/ CASTORS 5" OR GREATER	**	**
E1050	E1050	2260	W/C FULL/REC (E1050), FIX ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1060	E1060	2259	W/C FULL/REC (E1070), DETACH ARMS, SWING AWAY DETACH FOOTREST	**	**
E1065	E1065	2287	W/C POWER ATTACHMENT (E1065)	**
E1066	E1066	2247	BATTERY CHARGER (E1066)	**
E1069	E1069	2255	BATTERY, DEEP CYCLE (E1069)	**
E1070	E1070	2258	W/C FULL/REC (E1060), DETACH ARMS, SWING AWAY DET/ ELEV LEGRESTS	**	**
E1083	E1083	2263	W/C HEMI (E1083), FIX ARMS, SWING AWAY DETACH ABLE ELEV LEG REST	**	**
E1084	E1084	2262	W/C HEMI (E1084), DETACH ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1085	E1085	2264	W/C HEMI (E1085), FIX ARMS, SWING AWAY DETACH ABLE FOOT RESTS	**	**
E1086	E1086	2261	W/C HEMI (E1086), DETACH ARMS, SWING AWAY DETACH FOOTRESTS	**	**
E1087	E1087	2265	W/C HI STRENGTH  LT-WT (E1087), FIX ARMS, S/AWAY  ELEV LEG RESTS	**	**
E1088	E1088	2268	W/C HI STRENGTH LT-WGT (E1088), D/ ARMS, S/AWAY ELEV LEG RESTS	**	**
E1089	E1089	2266	W/C HI STRENGTH LT-WGT (E1089), FIX ARMS, S/AWAY DETACH FOOTREST	**	**
E1090	E1090	2267	W/C HI STRENGTH XX-XX (E1090), DETACH ARMS, S/AWAY D/FOOT RESTS	**	**
E1091	E1091	2321	W/C YOUTH, ANY TYPE (E1091)	**	**
E1092	E1092	2319	W/C WIDE HVY DUTY (E1092), DETACH ARMS S/AWAY DETACH ELEVAT LEGS	**	**
E1093	E1093	2320	W/C WIDE HVY DUTY (E1093), DETACH ARMS S/AWAY DETACH FOOTRESTS	**	**
E1100	E1100	2296	W/C SEMI-RECLINING (E1100), SWING AWAY DETACH ELEV LEG RESTS	**	**
E1110	E1110	2295	W/C SEMI-RECLINING (E1110), DETACH ARMS ELEV LEG REST	**	**
E1130	E1130	2303	W/C STANDARD (E1130), FIX OR SWING AWAY DETACH FOOTRESTS	**	**
E1140	E1140	2313	W/C (E1140), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1150	E1150	2314	W/C (E1150), DETACH ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2315	W/C (E1160), W/ FIX ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2396	W/C (E1160), W/FIX ARMS REMOVABLE FOOTRESTS	**	**
E1170	E1170	2241	W/C AMPUTEE (E1170), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1171	E1171	2242	W/C AMPUTEE (E1171), FIX ARMS, W/OUT FOOTRESTS OR LEGREST	**	**
E1172	E1172	2240	W/C AMPUTEE (E1172), DETACH ARMS W/OUT FOOTRESTS OR LEGREST	**	**
E1180	E1180	2239	W/C AMPUTEE (E1180), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1190	E1190	2238	W/C AMPUTEE (E1190), DETACH ARMS SWING AWAY DETACH ELEV LEGRESTS	**	**
E1195	E1195	2273	W/C HVY DUTY (E1195), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1200	E1200	2243	W/C AMPUTEE (E1200), FIX FULL LENGTH ARMS, S/AWAY  D/FOOTREST	**	**
E1210	E1210	2281	W/C MOTORIZED (E1210), FIX ARMS, S/AWAY DETACH ELEV LEG RESTS	COST+10%	**
E1211	E1211	2279	W/C MOTORIZED (E1211), DETACH ARMS , S/AWAY DETACH FOOT RESTS	COST+10%	**
E1212	E1212	2282	W/C MOTORIZED (E1212) , FIX ARMS, SWING AWAY DETACH FOOT RESTS	COST+10%	**
E1213	E1213	2280	W/C MOTORIZED (E1213), DETACH ARMS S/AWAY, DETACH ELEV LEG REST	COST+10%	**
E1220	E1220	2551	W/C CUSTOM (E1220)	COST+10%
E1220	E1220	2579	W/C XXWIDE (E1220)			COST+10%
E1230	E1230	2288	SCOOTER (E1230), THREE OR 4 WHEEL	**	**
E1240	E1240	2276	W/C LT-WGT (E1240), DETACH ARMS SWING AWAY DETACH, ELEV LEGREST	**	**
E1250	E1250	2278	W/C LT-WGT (E1250), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1260	E1260	2275	W/C LT-WGT (E1260), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1270	E1270	2277	W/C LT-WGT (E1270), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1280	E1280	2270	W/C HVY DUTY (E1280), DETACH ARMS ELEV LEGRESTS	**	**
E1285	E1285	2274	W/C HVY DUTY (E1285), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1290	E1290	2271	W/C HVY DUTY (E1290), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1295	E1295	2272	W/C HVY DUTY (E1295), FIX ARMS, ELEV LEGREST	**	**
E1300	DM570	2062	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	**
E1310	DM570	2061	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	COST+10%
E1353	E1353	2381	O2 REGULATOR (E1353)	**	**
E1355	E1355	2384	CYLINDER STAND/RACK (E1355)	**
E1372	E1372	2331	IMMERSION EXT HEATER (E1372) FOR NEBULIZER	**	**
E1375	E1375	2334	NEBULIZER PORT (E1375) W/ SMALL COMPRESSOR, W/ LIMITED FLOW	**
E1399	DM570	2568	ADAPTER (A9900), AC/DC	**
E1399	E1399	2586	APNEA MONITOR DOWNLOAD (E1399)			**
E1399	DM570	2552	BATH LIFT (E1399), CUSTOM	COST+10%
E1399	DM570	2563	BED WEDGE (E1399), 12"	**
E1399	DM570	2856	BEDROOM EQUIPMENT (E1399), CUSTOM	COST+10%
E1399	E1399	2525	BREAST PUMP, ELECTRIC (E1399)	**	**
E1399	DM570	2581	BREAST PUMP, INSTITUTIONAL (E1399)	**
E1399	E1399	2580	BREAST PUMP, MANUAL (E1399)	**
E1399	DM570	2593	COLD THERAPY UNIT, PAD (E1399)	**
E1399	E1399	2565	COMMODE (E1399), DROP ARM, HEAVY DUTY	**
E1399	E1399	2582	COMPRESSION PUMP BOOT (E1399)	**
E1399	E1399	2583	COMPRESSION PUMP, FOOT (E1399)		**
E1399	A9900	2569	CPAP HUMIDIFIER (A9900), HEATED	**	**
E1399	A9900	2635	CPAP/BIPAP SUPPLIES (A9900)	COST+10%
E1399	E1399	2327	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	COST+10%
E1399	E1220	2584	XXXX CHAIR (E1399), THREE POSITION RECLINING		**
E1399	DM570	6780	XXXXXX MONITOR (G0004)		**
E1399	E0265	2590	HOSP BED (E1399), ELECTRIC, XLONG, W/MATTRESS & SIDE RAILS	**	**
E1399	E0200	2868	LAMP, ULTRAVIOLET (E1399)	**
E1399	DM570	2588	MONITOR (E1399), XXXXX XXXXX		**
E1399	DM570	2529	O2 ANALYZER (A9900)	**	**
E1399	A9900	2594	O2 CONSERVATION DEVICE (A9900)	**	**
E1399	DM570	6775	OXIMETRY TEST (E1399)			**
E1399	DM570	2555	PATIENT LIFT, CUSTOM (E1399)	COST+10%
E1399	DM570	2561	PEAK FLOW METER (E1399)	**
E1399	E1399	4559	PEDIATRIC XXXXXX (E1399)	COST+10%
E1399	DM570	2567	PNEUMOGRAM (E1399)	**
E1399	E1399	2553	POSITIONING, CUSTOM (E1399)	COST+10%
E1399	E1399	2526	PULSE OXIMETER (E1399)	**	**
E1399	E1399	2527	PULSE OXIMETER W/ PROBE (E1399)	**	**
E1399	DM570	2562	SHOWER, HAND HELD (E1399)	**
E1399	DM570	2592	SLEEP STUDY, ADULT (E1399)	**
E1399	DM590	7483	STIMULATOR (E1399), MUSCLE, LOW VOLTAGE OR INTERFERENTIAL	COST+10%	COST+10%
E1399	DM570	2855	THERAPY EQUIPMENT, CUSTOM (E1399)	COST+10%
E1399	DM570	6774	THERAPY PERCUSSION, GENERATOR ONLY	**	**
E1399	E1399	7506	W/C, CUSTOM (E1399) MANUAL ADULT	COST+10%
E1399	E1399	7504	W/C, CUSTOM (E1399) MANUAL PEDIATRIC	COST+10%
E1399	E1399	7507	W/C, CUSTOM (E1399) POWER ADULT	COST+10%
E1399	E1399	7505	W/C, CUSTOM (E1399) POWER PEDIATRIC	COST+10%
E1399	E1399	2564	XXXXXX (E1399), HEAVY DUTY, EXTRA WIDE	**
E1399	E1399	2585	XXXXXX (E1399), HEMI	**
E1399	DM570	6873	WOUND SUCTION DEVICE (K0538)			COST+10%
E1400	E1390	2361	O2 CONC (E1390),MANUF SPEC MAXFLOWRATE = 2 LTS PER MIN@85%	**	**
G0015	DM570	6779	CARDIAC EVENT MONITOR (G0015)		**
K0163	DM590	3713	ERECTION SYSTEM, VACUUM (K0163)	**
K0183	DM590	2516	CPAP MASK (K0183)	**
K0184	DM590	2515	NASAL PILLOWS/SEALS (K0184) REPLACEMENT FOR NASAL APP/ DVC, PAIR	**
K0185	DM590	2514	CPAP HEADGEAR (K0185)	**
K0186	DM590	2513	CPAP CHIN STRAP (K0186)	**
K0187	DM590	2512	CPAP TUBING (K0187)	**
K0188	DM590	2511	CPAP FILTER (A9900), DISPOSABLE	**
K0189	DM590	2510	CPAP FILTER (A9900), NON-DISPOSABLE	**
K0268	DM590	2509	CPAP HUMIDIFIER (K0268), COOL	**
K0413	DM590	6889	MATTRESS (K0413), NONPOWERED, EQUIVALENT		**
E1399	E1399	7673	MATTRESS (E1399) V-CUE DYNAMIC AIR THERAPY			COST+10%
A4608	A9900	7621	CATHETER TRACH (A4608) 11CM 1 SCOOP	**
E1399	A9900	7664	COFFLATOR (E1399CF) MANUAL SECRETION MOBIL DEVICE		**
E0168B	A9900	7643	COMMODE (E0168B) HVY DUTY BEDSIDE CHAIR 000-000 XXX.	**
E0168C	A9900	7644	COMMODE (E0168C) HVY DUTY DROP ARM 451-850 LBS.	**
A6234	HH591	7626	DRESSING <16 SQ IN (A6234) HYDROCOLLOID DRESSING, EA	**
A6258	HH591	7627	DRESSING >16 SQ IN (A6258) TRANSPAREN FILM, EA	**
A46203	HH591	7625	DRESSING COMPOSITE <16 SQ IN (A46203) SELF ADH, EA	**
B9998B	DM590	7655	ENT (B9998B) EXT SET Y SITE F/KANGAROO PUMP	**
B9998C	DM590	7656	ENT (B9998C) EXT SET W/ CLAMP BASIC	**
B9998D	DM590	7657	ENT (B9998D) XXXXXXX GASTRIC RELIEF VLV	**
B9998E	DM590	7658	ENT (B9998E) GASTRO EXT SET	**
B9998F	DM590	7659	ENT (B9998F) GASTRO TUBE ANY SIZE MIC-KEY OR HIDE A PORT	**
E1399	A9900	7620	HUMID-VENT (E1399) ARTIFICIAL NOSE	**
E1399	A9900	0000	XXXX (E1399) UNIV SET UP W/MANIFOLD NEBULIZER	**
K0105	A9900	7639	IV POLE (K0105) ATTACH F/ W/C	**
E1399	A9900	7641	MECHANICAL SCALE (E1399) PEDIATRIC/NEONATAL	**
A7008	A9900	7661	NEBULIZER (A7008) KIT PREFILL W/STR H20 1L BAX	**
E1399	A9900	7663	O2 CONNECTOR (E1399) XXXX/IRRIGATION NOZZLE BAX	**
E1399	A9900	7615	O2 HUMIDIFIER (E1399) AQUA+NEONATAL EA HUD	**
E1399	A9900	7623	O2 SWIVEL (E1399) ADAPTER ANGLED STERILE	**
L8501	A9900	7624	SPEAKING VALVE (L8501) WHITE PAS	**
A4319	HH591	7629	STERILE WATER (A4319) F/IRRIG 1L BAX	**
A7001	HH591	7619	SUCTION BOTTLE (A7001) W/LID & TUBING	**
E1399	A9900	7616	SUCTION FILTER (E1399) BACTERIA	**
A6265	HH591	7628	TAPE ALL TYPES (A6265) EXCLUDING MICROFOAM, PER 18 SQ INCHES	**
A4481	A9900	7622	TRACH FILTER (A4481) BACTERIA ELECTROSTATIC	**
A4623	A9900	7618	TRACH INNER (A4623) CANNULA	**
A4621	A9900	7617	TRACH TUBE MASK (A4621) COLLAR OR HOLDER	**
A7010	A9900	7662	TUBING (A7010) AEROSOL CORRUGATED PER FOOT	**
E1399	A9900	7631	VENT ADAPTER (E1399) MDI HUD	**
A9900	A9900	7630	VENT BATTERY CHARGER (A9900) 12V GEL	**
E1399	A9900	7632	VENT CONNECTOR (E1399) PED OR ADULT OMNIFLEX DISP	**
E1399	A9900	7633	VENT FILTER (E1399) HYGROBAC S ELECTOSTATIC MAL	**
E1399	A9900	7634	VENT THERMOMETER (E1399) W/ ADAPTER	**
K0108	A9900	7638	W/C BRAKE EXTENSION (K0108) TIP BLK 10/PK	**
E1399	A9900	7635	XXXXXX BASKET (E1399) VINYL COATED	**
E0159	A9900	7640	XXXXXX BRAKE (E0159) ATTACHMENT	**
E0148	A9900	7636	XXXXXX HVY DUTY (E0148) FOLDING X-WIDE	**
E0149	A9900	7637	XXXXXX HVY DUTY (E0149) W/ WHEELS	**
E1399	A9900	7645	CPAP (E1399) DC BATTERY ADAPTER CABLE	**
E1399	A9900	7646	CPAP (E1399) EXHALATION PORT DISP	**
E1399	A9900	7647	CPAP (E1399) FUSE KIT INTERNATIONAL A/C	**
E1399	A9900	7648	CPAP (E1399) HUMIDIFIER CHAMBER KIT DISP	**
E1399	A9900	7649	CPAP (E1399) HUMIDIFIER CHAMBER REUSABLE	**
E1399	A9900	7650	CPAP (E1399) HUMIDIFIER MOUNTING TRAY	**
E1399	A9900	7651	CPAP (E1399) INVERTOR AC/DC	**
E1399	A9900	7652	CPAP (E1399) POWER CORD F/ARIA-SYNC	**
E1399	A9900	7653	CPAP (E1399) SHELL W/O PRESSURE TAP	**
A9900	DM590	7566	CPAP CALIBRATION SHELL (A9900)	**
A9900	DM590	7565	CPAP SHORT TUBING (A9900)	**
E0601	E0601	7690	VENT, CONTINUOUS POSITIVE (E0500) AIRWAY PRESSURE DEVICE	N/A	**
E0452	E0452	7691	VENT, BILEVEL INTERMITTENT (E0500) ASSIST DEVICE (BIPAP)	N/A	**

The following items were added in 2002

E0747	DM570	6875	STIMULATOR, OSTEOGENIC, ULTRASOUND	**
A9900	A9900	7695	GEL/SILICON GOLD SEAL CPAP/BIPAP MASK (A9900)	**
A9900	A9900	7701	VENT THERAPEUTIC ST BIPAP W/ BACKUP RATE (K0533)	N/A	**
A9900	A9900	7703	O2 SYS HELIOS PORT LIQUID, RENT (E1399)		COST+10%
HH591	HH591	7704	PUMP, EXT INFUSION, XXXX DIABECARE, INSULIN (E0784)	COST+10%
E0784	E0784	7731	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	**
A9900	A9900	7737	CPAP DREAM SEAL INTERFACE FOR USE WITH BREEZE MASK (A9900)	COST+10%
DM590	DM590	7738	CPAP CHIN STRAP DELUXE (K0186)	COST+10%
E1340	E1340	7768	W/C REPAIRS - CUSTOM (E1340)	COST+10%

The following may be charged under extraordinary circumstances:

E1399	E1399	4551	LABOR/SERVICE/SHIPPING CHARGES	COST+10%
E1399	E1399	2731	SHIPPING AND HANDLING FEES	COST+10%

The following may be charged if over and above routine on rental equipment:

E1350	E1350	2382	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	COST+10%
E1340	E1340	2554	W/C REPAIRS - STANDARD (E1340)	COST+10%
E1399	E1399	4552	MISCELLANEOUS SUPPLIES	COST+10%		COST+10%
E1399	E1399	2589	REPAIR (E1399), RESPIRATORY EQUIPMENT	COST+10%
E1399	E1399	4561	RESPIRATORY SUPPLIES (A4618)	COST+10%		COST+10%
E1399	E1399	4549	TENS/APNEA SUPPLIES	COST+10%		COST+10%

NOTES:

1.   Whether rental or purchase, rates include all shipping, labor and set-up.

2.   If item is rented, rates include all supplies to enable the equipment to function effectively, with the exception of supplies for CPAP, BIPAP, Ventilators, Suction, Enteral Pumps and CPM.  Such exception supplies will be billed at cost plus 10%.

3.   If item is rented, rates include repair and maintenance costs.

4.   If item is purchased, supplies, repair and maintenance will be billed at cost plus 10%.

5.   All equipment not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   Rates effective through 12/31/2003.

** Confidential Treatment Requested

Gentiva Health Network
EXHIBIT C1: TRADITIONAL HOME HEALTH CARE INDEMNITY FEE-FOR-SERVICE SCHEDULE
Effective January 1, 2003

The following Traditional Home Health Services have both Visit and Hourly rates.
Notes 1, 2, 3, 4, 5 and 6 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
CERTIFIED NURSES AIDE	**	**	**	**	**	**
HOME HEALTH  AIDE	**	**	**	**	**	**
LVN/LPN	**	**	**	**	**	**
LVN/LPN - HIGH TECH	**	**	**	**	**	**
PEDIATRIC HIGH TECH LVN/LPN	**	**	**	**	**	**
PEDIATRIC HIGH TECH RN	**	**	**	**	**	**
PEDIATRIC LVN/LPN	**	**	**	**	**	**
PEDIATRIC RN	**	**	**	**	**	**
RN	**	**	**	**	**	**
RN HIGH TECH  INFUSION	**	**	**	**	**	**
RN HIGH TECH OTHER	**	**	**	**	**	**

The following Traditional Home Health Services have Visit only rates.
Notes 1, 3, 4, 5, 7 and 8 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
DIABETIC NURSE	**	N/A	**	N/A	**	N/A
DIETITIAN	**	N/A	**	N/A	**	N/A
ENTEROSTOMAL THERAPIST	**	N/A	**	N/A	**	N/A
MATERNAL CHILD HEALTH	**	N/A	**	N/A	**	N/A
MEDICAL SOCIAL WORKER	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST	**	N/A	**	N/A	**	N/A
OCCUPATIONAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PHLEBOTOMIST	**	N/A	**	N/A	**	N/A
PHOTOTHERAPY PACKAGE SERVICE	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST	**	N/A	**	N/A	**	N/A
PHYSICAL THERAPIST ASSISTANT	X/X	X/X	X/X	X/X	X/X	X/X
PSYCHIATRIC NURSE	**	N/A	**	N/A	**	N/A
REHABILITATION NURSE	**	N/A	**	N/A	**	N/A
RESPIRATORY THERAPIST	**	N/A	**	N/A	**	N/A
RN ASSESSMENT, INITIAL	**	N/A	**	N/A	**	N/A
RN SKILLED NURSING ADMISSION VISIT	X/X	X/X	X/X	X/X	X/X	X/X
RN SKILLED NURSING VISIT-EXTENSIVE		N/A		N/A		N/A
SPEECH THERAPIST		N/A		N/A		N/A

The following Traditional Home Health Service has Hourly only rates.
Notes 3, 4 and 5 apply	Area 1		Area 2		Area 3
	Visit	Hour	Visit	Hour	Visit	Hour
HOMEMAKER	N/A	**	N/A	**	N/A	**

The following Traditional Home Health Service is priced on a Per Diem basis.
Notes 3, 4 and 5 apply	Xxxx 0		Xxxx 0		Xxxx 0
		Per Diem		Per Diem		Per Diem
COMPANION/LIVE IN		**		**		**

NOTES:

1.   Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration).

2.   Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3.

3.   CIGNA does not reimburse for travel time, weekend, holiday or evening differentials.

4.   Above prices have no exclusions.

5.   All services not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT.

7.   Respiratory Therapist visit utilization/costs to be reported with HME/RT.

8.   Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment.  Use requires special coordination.

** Confidential Treatment Requested

EXHIBIT  C2:  HOME INFUSION INDEMNITY FEE SCHEDULE
Effective January 1, 2003

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem	Primary or Multiple Therapy Dispensing Fee	Primary or Multiple Therapy Drug Discount off AWP
Ancillary Drugs		**	-15%
Biological Response Modifiers		**	-13%
Cardiac (Inotropic) Therapy	**		-15%
Chelation Therapy	**		-15%
Chemotherapy	**		-15%
Enteral Therapy	**		N/A
Enzyme Therapy	**		0%
Growth Hormone		**	-13%
IV Immune Globulin	**		0%
Other Injectable Therapies		**	-13%
Other Infusion Therapies	**		-15%
Pain Management Therapy	**		-15%
Steroid Therapy	**		-15%
Thrombolytic (Anticoagulation) Therapy	**		-15%
Synagis		**	-13%
Remodulin Therapy	**		-3%

The following Home Infusion Therapy service rates EXCLUDE drugs.  Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple anti-infective therapies
	Per Diem		Drug Discount Off AWP
Anti-Infectives - Primary Anti-Infective	**		**
Anti-Infectives - Multiple Anti-Infective	**

The following Home Infusion Therapy service rate EXCLUDES drugs.  Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective therapies
	Primary or Multiple Therapy Per Diem		Cost of Drug
Flolan Therapy	**
Flolan 0.5 mg vial			AWP
Flolan 1.5 mg vial			AWP
Flolan diluent vial			AWP

The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	Primary or Multiple Therapy Per Diem
Enteral Therapy	**
Hydration Therapy	**
Total Parenteral Nutrition	**

**  Confidential Treatment Requested

EXHIBIT  C2:  HOME INFUSION INDEMNITY FEE SCHEDULE
 

NOTES:

1.  Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.

2.   Per Diems INCLUDING drugs include ALL costs - including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc.

3.   "DISPENSING FEE" is defined as per each time the drug is dispensed by the home infusion provider.

4.   "PER DIEM" costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES.

5.   The per diem rate shall only be charged for those days the Participant receives medication.

6.   For home infusion pharmaceuticals not listed on fee schedule, AWP less 15% will apply.

7.   Case Managers should utilize Enteral Therapy WITHOUT drugs as an infusion benefit infrequently.  Generally, patient's requiring Enteral Therapy WITHOUT drugs should have services coordinated through the DME benefit.

** Confidential Treatment Requested

The following are for the stated item ONLY.  Unless otherwise noted, nursing, supplies, etc. are NOT included.
Blood Transfusion per Unit (Tubing, Filters)			**
Catheter Care Per Diem			**
Midline Insertion (Catheter & Supplies)			**
PICC Line Insertion (Catheter & Supplies)			**
Blood Product			COST PLUS 10%

** Confidential Treatment Requested

EXHIBIT  C2:  HOME INFUSION INDEMNITY FEE SCHEDULE
 

Factor Concentrates
		Vial price	Unit Price
Factor VII
Novoseven 1200MCG Vial		**
Novoseven 4800MCG Vial
Novoseven in 1200MCG or 4800MCG QTY			**
Factor VIII (Recombinant)
Recombinate			**
Kogenate or Helixate			**
Bioclate			N/A
Helixate FS			**
Kogenate FS			**
Refacto			**
Factor VIII (Monoclonal)
Hemofil-M or A. R. C. Method M			**
Monoclate P			**
Monarc-M			**
Factor VIII (Other)
Koate			**
Humate			**
Alphanate SDHT			**
Factor IX (Recombinant)
BeneFix			**
Factor IX (Monoclonal/High Purity)
Mononine			**
Alphanine			**
Factor IX (Other)
Konyne - 80			N/A
Proplex T			**
Bebulin			**
Profilnine SD			**
Anti-Inhibitor Complex
Autoplex-T			**
Feiba-VH			**
Hyate-C			**
HEMOSTATIC AGENTS
DDAVP - 10ml vial			AWP - 10%
Stimate  - 2.5xx xxxx			AWP - 10%
Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support; home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation

** Confidential Treatment Requested

GENTIVA HEALTH SERVICES CARECENTRIX EXHIBIT C3:  HOME MEDICAL EQUIPMENT/RESPIRATORY THERAPY INDEMNITY FEE-FOR-SERVICE SCHEDULE EFFECTIVE DATE:  JANUARY 1, 2003
HCPCS CODE	CHC CODE	GENTIVA CODE	DESCRIPTION	PURCHASE PRICE	RENTAL PRICE	DAILY PRICE
A4660	DM590	2520	MONITOR, BLOOD PRESSURE (A4660) W/STETH & CUFF	**
A4670	DM590	2518	MONITOR, BLOOD PRESSURE (A4670) , AUTOMATIC	**
A9900	A9900	7552	BREEZE (A9900) CPAP/BIPAP MASK	**
A9900	A9900	7553	FULL FACE (A9900) MIRAGE CPAP/BIPAP MASK	**
A9900	A9900	7554	GEL/SILICON (A9900) CPAP/BIPAP MASK INCL GLD SEAL,PHANTM,MONARCH	**
A9900	A9900	7556	SPECIALTY (A9900) CPAP/BIPAP MASK (PROFILE OR SIMPICITY)	**
DM590	HI531	2570	PUMP, ENTERAL (B9002)	**	**
B9998	DM590	6828	ENTERAL SUPPLIES (B9998)			COST+10%
DM590	DM570	7551	BACK-PACK (E1399),  FOR PORTABLE ENTERAL PUMP	**
DM590	DM590	2522	CANNULA, NASAL	COST+10%
DM590	DM590	7509	ENTERAL PUMP, PORTABLE (B9002)	COST+10%	COST+10%
DM590	DM590	7508	MASK, CPAP GEL OR SILICONE (K0183)	COST+10%
E0100	E0100	2020	CANE (E0100), ADJ OR FIX, W/ TIP	**
E0105	E0105	2021	CANE, QUAD (E0105)  OR THREE PRONG, ADJ OR FIX, W/ TIPS	**
E0110	E0110	2028	CRUTCHES, FOREARM (E0110),  ADJ OR FIX, PAIR, W/ TIPS, GRIPS	**
E0111	E0111	2023	CRUTCH FOREARM (E0111),  ADJ OR FIX, EACH, W/ TIP AND GRIPS	**
E0112	E0112	2027	CRUTCHES UNDERARM,  WOOD (E0112), ADJ OR FIX, PAIR, COMPLETE	**
E0113	E0113	2025	CRUTCH UNDERARM, WOOD (E0113),  ADJ OR FIX, EACH, COMPLETE	**
E0114	E0114	2026	CRUTCHES UNDERARM, ALUM (E0114),  ADJ OR FIX, PAIR, COMPLETE	**
E0116	E0116	2024	CRUTCH UNDERARM, ALUM (E0116),  ADJ OR FIX, EACH, COMPLETE	**
E0130	E0130	2037	XXXXXX, RIGID (E0130)  (PICKUP), ADJ OR FIX HEIGHT	**
E0135	E0135	2036	XXXXXX, FOLDING (E0135)  (PICKUP),  ADJ OR FIX HEIGHT	**
E0141	E0141	2040	XXXXXX, WHEELED (E0141),  W/OUT SEAT	**
E0142	DM570	2034	RIGID XXXXXX (E0142), WHEELED, W/ SEAT,	**
E0143	E0143	2029	XXXXXX FOLDING, WHEELED (E0143), W/OUT SEAT	**
E0145	DM570	2039	XXXXXX (E0145), WHEELED, W/ SEAT AND CRUTCH ATTACHMENTS	**
E0146	DM570	2038	XXXXXX, WHEELED, W/ SEAT (E0146)	**
E0147	E0147	2030	XXXXXX HVY DUT (E0147),  MULT BRAKING SYS, VAR WHEEL RESISTANCE	**
E0153	E0153	2032	CRUTCH PLATFORM ATTACHMENT (E0153), FOREARM EA	**
E0154	E0154	2033	XXXXXX PLATFORM ATTACHMENT (E0154), EA	**
E0155	E0155	2041	XXXXXX WHEEL ATTACHMENT (E0155), RIGID (PICKUP) XXXXXX	**
E0156	DM570	2035	XXXXXX SEAT ATTACHMENT (E0156)	**
E0157	E0157	2022	XXXXXX, CRUTCH ATTACHMENT (E0157), EACH	**
E0158	E0158	2031	XXXXXX LEG EXTENSIONS (E0158)	**
E0163	E0163	2047	COMMODE CHAIR, STATIONARY  (E0163),  W/ FIX ARMS	**
E0164	E0164	2045	COMMODE CHAIR, MOBILE  (E0164),  W/ FIX ARMS	**
E0165	E0165	2046	COMMODE CHAIR (E0165), STATIONARY, W/ DETACH ARMS	**
E0165	E0165	2591	COMMODE, XXWIDE(E0165)	**
E0166	E0166	2044	COMMODE CHAIR (E0166), MOBILE, W/ DETACH ARMS	**
E0167	E0167	2051	COMMODE CHAIR, PAIL OR PAN (E0167)	**
E0176	E0176	2142	CUSHION (E0176) OR AIR PRESSURE PAD, NON-POSITIONING	**
E0176	E0176	2394	REPLACEMENT PAD (E0176) ALTERNATING PRESS	**
E0177	E0177	2224	CUSHION OR WATER PRESS PAD (E0177), NONPOSITIONING	**
E0178	E0178	2160	CUSHION OR GEL PRESS PAD (E0178), NONPOSITIONING	**
E0179	E0179	2154	CUSHION (E0179) OR DRY PRESSURE PAD, NONPOSTIONING	**
E0180	E0180	2196	PUMP (E0180), ALTERNATING PRESSURES W/PAD	**	**
E0181	E0181	2197	PUMP (E0181), ALTERNATING PRESS W/PAD,  HVY DUTY	**	**
E0184	E0184	2074	MATTRESS, DRY PRESSURE (E0184)	**
E0185	E0185	2076	MATTRESS (E0185), GEL OR GEL-LIKE PRESSURE PAD	**
E0186	E0186	2064	MATTRESS, AIR PRESSURE (E0186)	**
E0187	E0187	2099	MATTRESS, WATER PRESSURE (E0187)	**
E0188	DM570	2217	PAD, SYNTHETIC SHEEPSKIN (A9900)	**
E0189	DM570	2177	PAD, LAMBSWOOL SHEEPSKIN (E0189), ANY SIZE	COST+10%
E0192	E0192	2573	CUSHION, XXX FOR W/C (E0192)	**	**
E0192	E0192	2572	CUSHION, ROHO FOR W/C  (E0192)	**	**
E0192	E0192	2178	W/C PAD (E0192), LOW PRESS AND POSITIONING EQUALIZATION	**	**
E0193	E0193	2098	MATTRESS, LOW AIR LOSS (E0193), INCL. BED	**	**	**
E0194	DM570	2063	AIR FLUIDIZED BED (E0194)		**	**
E0196	E0196	2077	MATTRESS, GEL PRESSURE (E0196)	**
E0197	E0197	2065	MATTRESS, AIR PRESSURE PAD (E0197)	**
E0198	E0198	2100	MATTRESS (E0198), WATER PRESSURE PAD	**
E0199	E0199	2075	MATTRESS, DRY PRESSURE PAD (E0199)	**
E0200	E0200	2228	HEAT LAMP (E0200),  W/OUT STAND, INCL/BULB, OR INFRARED ELEMENT	**
E0202	E0202	2229	PHOTOTHERAPY (BILIRUBIN) (E0202), LIGHT WIT			**
E0202	E0202	2524	PHOTOTHERAPY, BILI BLANKET (E0202)			**
E0205	E0205	2227	HEAT LAMP (E0205), WITH STAND, INCL/ BULB, OR INFRARED ELEMENT	**
E0210	DM570	2156	HEATING PAD, STANDARD (E0210)	**
E0215	DM570	2155	HEATING PAD (E0215), ELECTRIC, MOIST	**
E0218	DM570	2560	COLD THERAPY UNIT (E0218)	**	**	**
E0235	DM570	2187	PARAFFIN BATH UNIT, PORT (E0235)	**
E0236	DM570	2199	PUMP (E0236) FOR WATER CIRCULATING PAD	**
E0237	DM570	2223	HEAT COLD WATER (E0237) CIRCULATING PAD W/PUMP	**
E0238	DM570	2179	HEATING PAD (E0238), MOIST, NON-ELECTRIC	**
E0241	DM570	2867	BATH TUB RAIL (E0241), WALL, L-SHAPE	**
E0241	DM570	2862	BATH TUB RAIL, WALL, 12" (E0241)	**
E0241	DM570	2863	BATH TUB RAIL, WALL, 16" (E0241)	**
E0241	DM570	2864	BATH TUB RAIL, WALL, 18" (E0241)	**
E0241	DM570	2865	BATH TUB RAIL, WALL, 24" (E0241)	**
E0241	DM570	2866	BATH TUB RAIL, WALL, 36" (E0241)	**
E0241	DM570	2043	BATH TUB RAIL, WALL, UNSPECIFIED SIZE	COST+10%
E0242	DM570	2042	BATH TUB RAIL, FLOOR BASE (E0242)	**
E0243	DM570	2056	TOILET RAIL, EACH (E0243)	**
E0244	E0244	2587	TOILET SEAT (E0244) RAISED WITH ARMS	**
E0244	E0244	2052	TOILET SEAT, RAISED (E0244)	**
E0245	DM570	2575	BATH BENCH WITH BACK (E0245)	**
E0245	DM570	2058	BATH TUB STOOL OR BENCH (E0245)	**
E0245	DM570	2578	TRANSFER BENCH, NON-PADDED (E0245)	**
E0245	DM570	2577	TRANSFER BENCH, PADDED (E0245)	**
E0246	DM570	2057	TRANSFER TUB RAIL(E0246), ATTACHMENT	**
E0249	DM570	2186	HEAT UNIT (E0249), WATER CIRCULATING PAD	**
E0255	E0255	2090	HOSP BED (E0255), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/ MATTRESS	**	**
E0256	E0256	2091	HOSP BED (E0256), VAR HEIGHT, HI-LO, W/ SIDE RAILS, W/O MATTRESS	**	**
E0260	E0260	2083	HOSP BED (E0260), SEMI-ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0261	E0261	2084	HOSP BED (E0261), SEMI-ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0265	E0265	2086	HOSP BED (E0265), TOTAL ELEC, W/ SIDE RAILS, W/ MATTRESS	**	**
E0266	E0266	2087	HOSP BED (E0266), TOTAL ELEC, W/ SIDE RAILS, W/OUT MATTRESS	**	**
E0271	E0271	2096	MATTRESS, INNERSPRING (E0271)	**
E0272	E0272	2095	MATTRESS, FOAM RUBBER (E0272)	**
E0273	DM570	2068	BED BOARD (E1399)	**
E0274	DM570	2097	OVER-BED TABLE (E0274)	**
E0275	E0275	2071	BED PAN, STANDARD (E0275), METAL OR PLASTIC	**
E0276	E0276	2070	BED PAN, FRACTURE (E0276), METAL OR PLASTIC	**
E0277	E0277	2066	MATTRESS (E0277), LOW AIR LOSS, ALT PRESSURE	**	**
E0280	DM570	2069	BED CRADLE, ANY TYPE (E1399)	**
E0292	E0292	2092	HOSP BED (E0292), VAR HEIGHT, HI-LO, W/OUT S/ RAILS, W/ MATTRESS	**	**
E0293	E0293	2093	HOSP BED (E0293), VAR HEIGHT, HI-LO,  NO SIDE RAILS, NO MATTRESS	**	**
E0294	E0294	2085	HOSP BED (E0294), SEMI-ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0295	E0295	2094	HOSP BED (E0295), SEMI-ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0296	E0296	2089	HOSP BED (E0296), TOTAL ELEC, W/OUT SIDE RAILS, W/OUT MATTRESS	**	**
E0297	E0297	2088	HOSP BED (E0297), TOTAL ELEC, W/OUT SIDE RAILS, W/ MATTRESS	**	**
E0305	E0305	2073	BED SIDE RAILS (E0305), HALF LENGTH	**
E0310	E0310	2072	BED SIDE RAILS (E0310), FULL LENGTH	**
E0315	DM570	2067	BED ACCESSORIES: BOARDS OR TABLES, ANY TYPE	**
E0325	E0325	2060	URINAL; MALE (E0325), JUG-TYPE, ANY MATERIAL	**
E0326	E0326	2059	URINAL; FEMALE (E0326), JUG-TYPE, ANY MATERIAL	**
E0372	E0372	7008	MATTRESS (E0372) POWERED AIR OVERLAY	**	**	**
E0410	E0444	2369	O2 CONTENTS, LIQUID (E0444), PER POUND	**
E0416	E0443	2371	O2 REFILL FOR PORT (E0443) GAS SYSTEM ONLY, UP TO 23 CUBIC FEET	**
E0424	E0424	2385	O2 SYS STATIONARY (E0424) COMPR GAS, RENT		**
E0430	E0430	2374	O2 SYS PORT GAS, PURCH (E0430)	**
E0431	E0431	2574	O2 SYS PORT GAS, LIGHTWEIGHT (E0431) W/CONSERV DEVICE,NO CONTENT	**	**
E0431	E0431	2375	O2 SYS PORT GAS, RENT (E0431)		**
E0434	E0434	2377	O2 SYS PORT LIQUID,RENT (E0434)		**
E0435	E0435	2376	O2 SYS PORT LIQUID, PURCH (E0435)	**
E0439	E0439	2388	O2 SYS STATIONARY (E0439) LIQUID, RENT		**
E0440	E0440	2387	O2 SYS STATIONARY (E0440) LIQUID, PURCH	**
E0443	E0400	2869	O2 CONTENTS, H/K CYLINDER (E0400), 200-300 CUBIC FT	**
E0444	E0444	2379	O2 CONTENTS, PORT LIQUID (E0444), PER UNIT (1 UNIT = 1 LB.)	**
E0450	E0450	7555	POSITIVE PRESSURE VENTS (E0450)(E.G. T-BIRD)		**
E0450	E0450	2392	VENTILATOR VOLUME (E0450), STATIONARY OR PORT	**	**
E0450	E0450	7522	VENTILATOR, VOLUME, (E0450) EMERGENCY BACKUP UNIT	COST+10%	**
E0452	E0452	2332	BILEVEL INTERMITTENT (E0452) ASSIST DEVICE,(BIPAP)	**	**
E0453	E0453	2390	VENTILATOR THERAPEUTIC (E0453); FOR USE 12 HOURS OR LESS PER DAY	**	**
E0455	E0455	2372	O2 TENT (E0455), EXCLUDING CROUP OR PEDIATRIC TENTS	**	**
E0457	E0457	2323	CHEST SHELL (CUIRASS) (E0457)	**	**
E0459	E0459	2324	CHEST WRAP (E0459)	**	**
E0460	E0460	2339	VENTILATOR (E0460), NEGATIVE PRESSURE , PORTABLE OR STATIONARY	**	**
E0480	DM570	2373	PERCUSSOR (E0480), ELEC OR PNEUM, HOME MODEL	**	**
E0500	E0500	0000	XXXX , W/ BUILT-IN NEB (E0500) MAN OR AUTO VALVES; INT/EXT POWER	**	**
E0550	E0550	2328	HUMIDIFIER (E0550) DURABLE FOR EXTENSIV SUP/ HUMID W/ IPPB OR O2	**	**
E0555	E0555	2330	HUMIDIFIER (E0555), DURABLE, GLASS, FOR USE W/ REG OR FLOWMETER	COST+10%
E0565	E0565	2325	COMPRESSOR, AIR POWER (E0565)	**	**
E0570	E0570	2336	NEBULIZER, W/ COMPRESSOR (E0570)	**
E0575	DM570	2571	NEBULIZER (E0575), ULTRASONIC, AC/DC	**	**
E0575	DM570	2338	NEBULIZER; ULTRASONIC (E0575)	**	**
E0585	E0585	2337	NEBULIZER(E0585), W/ COMPRESSOR AND HEATER	**	**
E0600	E0600	2389	SUCTION PUMP (E0600), HOME MODEL	**	**
E0600	E0600	7523	SUCTION UNIT, (E0600), PORTABLE AC/DC	COST+10%	COST+10%
E0601	E0601	2326	CONTINUOUS POSITVE (E0601) AIRWAY PRESSURE DEVICE (CPAP)	**	**
E0601	E0601	6965	CPAP, SELF TITRATING (E0601)	**	**
E0605	DM570	2391	VAPORIZER, ROOM TYPE (E0605)	**
E0606	DM570	2380	POSTURAL DRAINAGE BOARD (E0606)	**
E0607	E0607	6874	MONITOR, B/GLUCOSE (E0607) ACCUCHEK AD	**
E0607	E0607	2164	MONITOR, BLOOD GLUCOSE (E0607)	**
E0608	E0608	2322	APNEA MONITOR (E0608)	**	**
E0608	E0608	2576	APNEA MONITOR (E0608) W/MEM (INCL SMART)	**	**
E0609	E0609	2146	MONITOR, BLOOD GLUCOSE (E0609) W/SPECIAL FEATURES	**
E0621	E0621	2215	PATIENT LIFT (E0621), SLING OR SEAT, CANVAS OR NYLON	**
E0625	DM570	2191	PATIENT LIFT (E0625), KARTOP, BATHROOM OR TOILET	COST+10%
E0627	E0627	4553	HIP CHAIR (E0627)	**	**
E0627	DM570	2395	SEAT LIFT CHAIR/MOTORIZED (E0627)	**
E0627	DM570	2205	SEAT LIFT MECH (E0627)  INCORPORATED INTO A COMB LIFT-CHAIR MECH	**
E0630	E0630	2190	PATIENT LIFT, HYDRAULIC (E0630), W/ SEAT OR SLING	**	**
E0635	DM570	2189	PATIENT LIFT (E0635), ELEC W/ SEAT OR SLING	**
E0650	E0650	2192	PNEUM COMPRESSOR (E0650), NON-SEG HOME MODEL	**	**
E0651	E0651	2194	PNEUM COMPRESSOR (E0651), SEG HOME MODEL W/OUT CALIB GRAD PRES	**	**
E0652	E0652	2193	PNEUM COMPRESSOR (E0652), SEG HOME MODEL W/ CALIB GRAD PRES	**	**
E0655	E0655	2182	PNEUM COMPRESSOR (E0655), NON-SEG APPLIANCE, HALF ARM	**
E0660	E0660	2181	PNEUM COMPRESSOR (E0660), NON-SEG APPLIANCE, FULL LEG	**
E0665	E0665	2180	PNEUM COMPRESSOR (E0665), NON-SEG APPLIANCE, FULL ARM	**
E0666	E0666	2183	PNEUM COMPRESSOR (E0666), NON-SEG APPLIANCE, HALF LEG	**
E0667	E0667	2210	PNEUM APPLIANCE (E0667), SEG, FULL LEG	**
E0668	E0668	2209	PNEUM APPLIANCE (E0668), SEG, FULL ARM	**
E0669	E0669	2212	PNEUM APPLIANCE (E0669), SEG, HALF LEG	**
E0670	E0670	2211	PNEUM APPLIANCE (E0670), SEG, HALF ARM	**
E0671	E0671	2207	PNEUM APPLIANCE (E0671), SEG GRAD PRESS, FULL LEG	**
E0672	E0672	2206	PNEUM APPLIANCE (E0672), SEG GRAD PRESS, FULL ARM	**
E0673	E0673	2208	PNEUM APPLIANCE (E0673), SEG GRAD PRESS, HALF LEG	**
E0690	DM570	2221	ULTRAVIOLET CABINET (E0690), APPROPRIATE FOR HOME USE	**
E0700	DM570	2204	SAFETY EQUIP (E0700) (E.G., BELT, HARNESS OR VEST)	COST+10%
E0710	DM570	2202	RESTRAINTS (E0710), ANY TYPE (BODY, CHEST, WRIST OR ANKLE)	**
E0720	E0720	2219	TENS (E0720), TWO LEAD, LOCALIZED STIMULATION	**	**
E0730	E0730	2218	TENS (E0730), FOUR LEAD, LARGER AREA/MULTIPLE NERVE STIMULATION	**	**
E0731	E0731	2159	TENS OR NMES (E0731), CONDUCTIVE GARMENT	**
E0744	E0744	2120	STIMULATOR (E0744), NEUROMUSCULAR FOR SCOLIOSIS	**	**
E0745	E0745	2121	STIMULATOR (E0745), NEUROMUSCULAR, ELECTRONIC SHOCK UNIT	**	**
E0745	E0745	6915	STIMULATOR FOUR CH (E0745), NEUROMUSCULAR	**	**
E0746	DM570	2109	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	**	**
E0747	DM570	2122	STIMULATOR (E0747), OSTEOGENIC, NON-INVASIVE	**
E0748	DM570	2124	STIMULATOR (E0748), OSTEOGENIC NON-INVASIVE, SPINAL APPLICATIONS	**
E0755	DM570	2157	STIMULATOR (E0755), ELECTRONIC SALIVARY REFLEX, NON INVASIVE	**
E0776	E0776	2175	IV POLE (E0776)	**	**
E0784	E0784	2158	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	**
E0784	E0784	6771	PUMP (E0784), INSULIN EXT INFUSION DISETRONICS OR OTHER	**
E0840	E0840	2133	TRACTION FRAME (E0840), ATTACH TO HEADBOARD, CERVICAL TRACTION	**
E0850	E0850	2134	TRACTION STAND (E0850), FREE STANDING, CERVICAL TRACTION	**	**
E0855	E0855	7484	TRACTION (E0855), W/O FRAME OR STAND	COST+10%
E0860	E0860	2130	TRACTION EQUIP (E0860), OVERDOOR, CERVICAL	**
E0870	E0870	2131	TRACTION FRAME (E0870), ATTACH TO FOOTBOARD, EXTREMITY, BUCKS	**	**
E0880	E0880	2135	TRACTION STAND (E0880) FREE/STAND EXTREMITY TRACTION, EG, BUCK'S	**	**
E0890	E0890	2132	TRACTION FRAME (E0890), ATTACH TO FOOTBOARD, PELVIC TRACTION	**	**
E0900	E0900	2136	TRACTION STAND (E0900) FREE/ STAND PELVIC TRACTION,( EG, BUCK'S)	**	**
E0910	E0910	2138	TRAPEZE BARS (E0910), A/K/A PT HELPER, ATTACH TO BED W/ GRAB BAR	**	**
E0920	E0920	2111	FRACTURE FRAME (E0920), ATTACH TO BED, INCLUDING WEIGHTS	**	**
E0935	E0935	2125	PASSIVE MOTION (E0935) EXERCISE DEVICE			**
E0935	E0935	2859	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE			**
E0935	E0935	2860	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW			**
E0935	E0935	2857	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND			**
E0935	E0935	2858	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER			**
E0935	E0935	2861	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST			**
E0940	E0940	2137	TRAPEZE BAR (E0940), FREE STANDING, COMPLETE W/ GRAB BAR	**	**
E0941	E0941	2116	TRACTION DEVICE (E0941), GRAVITY ASSISTED	**	**
E0942	E0942	0000	XXXXXXX/XXXXXX (E0942), CERVICAL HEAD	**
E0944	E0944	2126	HARNESS (E0944), PELVIC BELT, BOOT	**
E0945	DM570	2110	HARNESS (E0945), EXTREMITY BELT	**
E0946	E0946	2115	FRACTURE, FRAME (E0946), DUAL W/ CROSS BARS, ATTACH TO BED	**	**
E0947	E0947	2113	FRACTURE FRAME (E0947), ATTACHMENTS FOR COMPLEX PELVIC TRACTION	COST+10%	COST+10%
E0948	E0948	2112	FRACTURE FRAME (E0948) ATTACHMENTS FOR COMPLEX CERVICAL TRACTION	COST+10%	COST+10%
E0950	DM570	2139	TRAY (E0950)	**
E0958	E0958	2307	W/C PART ATTACHMENT (E0958) TO CONVERT ANY W/C TO ONE ARM DRIVE	**
E0959	E0959	2237	W/C PART AMPUTEE ADAPTER(E0959) (COMPENSATE FOR TRANS OF WEIGHT)	**
E0962	E0962	2232	CUSHION FOR WC 1" (E0962)	**
E0963	E0963	2233	CUSHION FOR WC 2" (E0963)	**
E0964	E0964	2234	CUSHION FOR WC 3" (E0964)	**
E0965	E0965	2235	CUSHION FOR WC 4" (E0965)	**
E0972	DM570	2230	TRANSFER BOARD OR DEVICE (E0972)	**
E0977	E0977	2317	CUSHION, WEDGE FOR W/C (E0977)	**
E0978	E0978	2248	BELT, SAFETY (E0978) W/ AIRPLANE BUCKLE, W/C	**
E0979	DM570	2249	BELT, SAFETY (E0979) W/ VELCRO CLOSURE, W/C	**
E0980	DM570	2292	SAFETY VEST (E0980), W/C	**
E1031	E1031	2291	ROLLABOUT CHAIR (E1031), W/ CASTORS 5" OR GREATER	**	**
E1050	E1050	2260	W/C FULL/REC (E1050), FIX ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1060	E1060	2259	W/C FULL/REC (E1070), DETACH ARMS, SWING AWAY DETACH FOOTREST	**	**
E1065	E1065	2287	W/C POWER ATTACHMENT (E1065)	**
E1066	E1066	2247	BATTERY CHARGER (E1066)	**
E1069	E1069	2255	BATTERY, DEEP CYCLE (E1069)	**
E1070	E1070	2258	W/C FULL/REC (E1060), DETACH ARMS, SWING AWAY DET/ ELEV LEGRESTS	**	**
E1083	E1083	2263	W/C HEMI (E1083), FIX ARMS, SWING AWAY DETACH ABLE ELEV LEG REST	**	**
E1084	E1084	2262	W/C HEMI (E1084), DETACH ARMS, SWING AWAY DETACH ELEV LEG RESTS	**	**
E1085	E1085	2264	W/C HEMI (E1085), FIX ARMS, SWING AWAY DETACH ABLE FOOT RESTS	**	**
E1086	E1086	2261	W/C HEMI (E1086), DETACH ARMS, SWING AWAY DETACH FOOTRESTS	**	**
E1087	E1087	2265	W/C HI STRENGTH  LT-WT (E1087), FIX ARMS, S/AWAY  ELEV LEG RESTS	**	**
E1088	E1088	2268	W/C HI STRENGTH LT-WGT (E1088), D/ ARMS, S/AWAY ELEV LEG RESTS	**	**
E1089	E1089	2266	W/C HI STRENGTH LT-WGT (E1089), FIX ARMS, S/AWAY DETACH FOOTREST	**	**
E1090	E1090	2267	W/C HI STRENGTH XX-XX (E1090), DETACH ARMS, S/AWAY D/FOOT RESTS	**	**
E1091	E1091	2321	W/C YOUTH, ANY TYPE (E1091)	**	**
E1092	E1092	2319	W/C WIDE HVY DUTY (E1092), DETACH ARMS S/AWAY DETACH ELEVAT LEGS	**	**
E1093	E1093	2320	W/C WIDE HVY DUTY (E1093), DETACH ARMS S/AWAY DETACH FOOTRESTS	**	**
E1100	E1100	2296	W/C SEMI-RECLINING (E1100), SWING AWAY DETACH ELEV LEG RESTS	**	**
E1110	E1110	2295	W/C SEMI-RECLINING (E1110), DETACH ARMS ELEV LEG REST	**	**
E1130	E1130	2303	W/C STANDARD (E1130), FIX OR SWING AWAY DETACH FOOTRESTS	**	**
E1140	E1140	2313	W/C (E1140), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1150	E1150	2314	W/C (E1150), DETACH ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2315	W/C (E1160), W/ FIX ARMS, SWING AWAY DETACH ELEVAT LEGRESTS	**	**
E1160	E1160	2396	W/C (E1160), W/FIX ARMS REMOVABLE FOOTRESTS	**	**
E1170	E1170	2241	W/C AMPUTEE (E1170), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1171	E1171	2242	W/C AMPUTEE (E1171), FIX ARMS, W/OUT FOOTRESTS OR LEGREST	**	**
E1172	E1172	2240	W/C AMPUTEE (E1172), DETACH ARMS W/OUT FOOTRESTS OR LEGREST	**	**
E1180	E1180	2239	W/C AMPUTEE (E1180), DETACH ARMS SWING AWAY DETACH FOOTRESTS	**	**
E1190	E1190	2238	W/C AMPUTEE (E1190), DETACH ARMS SWING AWAY DETACH ELEV LEGRESTS	**	**
E1195	E1195	2273	W/C HVY DUTY (E1195), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1200	E1200	2243	W/C AMPUTEE (E1200), FIX FULL LENGTH ARMS, S/AWAY  D/FOOTREST	**	**
E1210	E1210	2281	W/C MOTORIZED (E1210), FIX ARMS, S/AWAY DETACH ELEV LEG RESTS	COST+10%	**
E1211	E1211	2279	W/C MOTORIZED (E1211), DETACH ARMS , S/AWAY DETACH FOOT RESTS	COST+10%	**
E1212	E1212	2282	W/C MOTORIZED (E1212) , FIX ARMS, SWING AWAY DETACH FOOT RESTS	COST+10%	**
E1213	E1213	2280	W/C MOTORIZED (E1213), DETACH ARMS S/AWAY, DETACH ELEV LEG REST	COST+10%	**
E1220	E1220	2551	W/C CUSTOM (E1220)	COST+10%
E1220	E1220	2579	W/C XXWIDE (E1220)			COST+10%
E1230	E1230	2288	SCOOTER (E1230), THREE OR 4 WHEEL	**	**
E1240	E1240	2276	W/C LT-WGT (E1240), DETACH ARMS SWING AWAY DETACH, ELEV LEGREST	**	**
E1250	E1250	2278	W/C LT-WGT (E1250), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1260	E1260	2275	W/C LT-WGT (E1260), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1270	E1270	2277	W/C LT-WGT (E1270), FIX ARMS, SWING AWAY DETACH ELEV LEGRESTS	**	**
E1280	E1280	2270	W/C HVY DUTY (E1280), DETACH ARMS ELEV LEGRESTS	**	**
E1285	E1285	2274	W/C HVY DUTY (E1285), FIX ARMS, SWING AWAY DETACH FOOTREST	**	**
E1290	E1290	2271	W/C HVY DUTY (E1290), DETACH ARMS SWING AWAY DETACH FOOTREST	**	**
E1295	E1295	2272	W/C HVY DUTY (E1295), FIX ARMS, ELEV LEGREST	**	**
E1300	DM570	2062	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	**	**
E1310	DM570	2061	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	COST+10%
E1353	E1353	2381	O2 REGULATOR (E1353)	**	**
E1355	E1355	2384	CYLINDER STAND/RACK (E1355)	**
E1372	E1372	2331	IMMERSION EXT HEATER (E1372) FOR NEBULIZER	**	**
E1375	E1375	2334	NEBULIZER PORT (E1375) W/ SMALL COMPRESSOR, W/ LIMITED FLOW	**
E1399	DM570	2568	ADAPTER (A9900), AC/DC	**
E1399	E1399	2586	APNEA MONITOR DOWNLOAD (E1399)			**
E1399	DM570	2552	BATH LIFT (E1399), CUSTOM	COST+10%
E1399	DM570	2563	BED WEDGE (E1399), 12"	**
E1399	DM570	2856	BEDROOM EQUIPMENT (E1399), CUSTOM	COST+10%
E1399	E1399	2525	BREAST PUMP, ELECTRIC (E1399)	**	**
E1399	DM570	2581	BREAST PUMP, INSTITUTIONAL (E1399)	**
E1399	E1399	2580	BREAST PUMP, MANUAL (E1399)	**
E1399	DM570	2593	COLD THERAPY UNIT, PAD (E1399)	**
E1399	E1399	2565	COMMODE (E1399), DROP ARM, HEAVY DUTY	**
E1399	E1399	2582	COMPRESSION PUMP BOOT (E1399)
E1399	E1399	2583	COMPRESSION PUMP, FOOT (E1399)		**
E1399	A9900	2569	CPAP HUMIDIFIER (A9900), HEATED	**	**
E1399	A9900	2635	CPAP/BIPAP SUPPLIES (A9900)	COST+10%
E1399	E1399	2327	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	COST+10%
E1399	E1220	2584	XXXX CHAIR (E1399), THREE POSITION RECLINING		**
E1399	DM570	6780	XXXXXX MONITOR (G0004)		**
E1399	E0265	2590	HOSP BED (E1399), ELECTRIC, XLONG, W/MATTRESS & SIDE RAILS	**	**
E1399	E0200	2868	LAMP, ULTRAVIOLET (E1399)	**
E1399	DM570	2588	MONITOR (E1399), XXXXX XXXXX		**
E1399	DM570	2529	O2 ANALYZER (A9900)	**	**
E1399	A9900	2594	O2 CONSERVATION DEVICE (A9900)	**	**
E1399	DM570	6775	OXIMETRY TEST (E1399)			**
E1399	DM570	2555	PATIENT LIFT, CUSTOM (E1399)	COST+10%
E1399	DM570	2561	PEAK FLOW METER (E1399)	**
E1399	E1399	4559	PEDIATRIC XXXXXX (E1399)	COST+10%
E1399	DM570	2567	PNEUMOGRAM (E1399)	**
E1399	E1399	2553	POSITIONING, CUSTOM (E1399)	COST+10%
E1399	E1399	2526	PULSE OXIMETER (E1399)	**	**
E1399	E1399	2527	PULSE OXIMETER W/ PROBE (E1399)	**	**
E1399	DM570	2562	SHOWER, HAND HELD (E1399)	**
E1399	DM570	2592	SLEEP STUDY, ADULT (E1399)	**
E1399	DM590	7483	STIMULATOR (E1399), MUSCLE, LOW VOLTAGE OR INTERFERENTIAL	COST+10%	COST+10%
E1399	DM570	2855	THERAPY EQUIPMENT, CUSTOM (E1399)	COST+10%
E1399	DM570	6774	THERAPY PERCUSSION, GENERATOR ONLY	**	**
E1399	E1399	7506	W/C, CUSTOM (E1399) MANUAL ADULT	COST+10%
E1399	E1399	7504	W/C, CUSTOM (E1399) MANUAL PEDIATRIC	COST+10%
E1399	E1399	7507	W/C, CUSTOM (E1399) POWER ADULT	COST+10%
E1399	E1399	7505	W/C, CUSTOM (E1399) POWER PEDIATRIC	COST+10%
E1399	E1399	2564	XXXXXX (E1399), HEAVY DUTY, EXTRA WIDE	**
E1399	E1399	2585	XXXXXX (E1399), HEMI	**
E1399	DM570	6873	WOUND SUCTION DEVICE (K0538)			COST+10%
E1400	E1390	2361	O2 CONC (E1390),MANUF SPEC MAXFLOWRATE = 2 LTS PER MIN@85%	**	**
G0015	DM570	6779	CARDIAC EVENT MONITOR (G0015)		**
K0163	DM590	3713	ERECTION SYSTEM, VACUUM (K0163)	**
K0183	DM590	2516	CPAP MASK (K0183)	**
K0184	DM590	2515	NASAL PILLOWS/SEALS (K0184) REPLACEMENT FOR NASAL APP/ DVC, PAIR	**
K0185	DM590	2514	CPAP HEADGEAR (K0185)	**
K0186	DM590	2513	CPAP CHIN STRAP (K0186)	**
K0187	DM590	2512	CPAP TUBING (K0187)	**
K0188	DM590	2511	CPAP FILTER (A9900), DISPOSABLE	**
K0189	DM590	2510	CPAP FILTER (A9900), NON-DISPOSABLE	**
K0268	DM590	2509	CPAP HUMIDIFIER (K0268), COOL	**
K0413	DM590	6889	MATTRESS (K0413), NONPOWERED, EQUIVALENT		**
E1399	E1399	7673	MATTRESS (E1399) V-CUE DYNAMIC AIR THERAPY			COST+10%
A4608	A9900	7621	CATHETER TRACH (A4608) 11CM 1 SCOOP	**
E1399	A9900	7664	COFFLATOR (E1399CF) MANUAL SECRETION MOBIL DEVICE		**
E0168B	A9900	7643	COMMODE (E0168B) HVY DUTY BEDSIDE CHAIR 000-000 XXX.	**
E0168C	A9900	7644	COMMODE (E0168C) HVY DUTY DROP ARM 451-850 LBS.	**
A6234	HH591	7626	DRESSING <16 SQ IN (A6234) HYDROCOLLOID DRESSING, EA	**
A6258	HH591	7627	DRESSING >16 SQ IN (A6258) TRANSPAREN FILM, EA	**
A46203	HH591	7625	DRESSING COMPOSITE <16 SQ IN (A46203) SELF ADH, EA	**
B9998B	DM590	7655	ENT (B9998B) EXT SET Y SITE F/KANGAROO PUMP	**
B9998C	DM590	7656	ENT (B9998C) EXT SET W/ CLAMP BASIC	**
B9998D	DM590	7657	ENT (B9998D) XXXXXXX GASTRIC RELIEF VLV	**
B9998E	DM590	7658	ENT (B9998E) GASTRO EXT SET	**
B9998F	DM590	7659	ENT (B9998F) GASTRO TUBE ANY SIZE MIC-KEY OR HIDE A PORT	**
E1399	A9900	7620	HUMID-VENT (E1399) ARTIFICIAL NOSE	**
E1399	A9900	0000	XXXX (E1399) UNIV SET UP W/MANIFOLD NEBULIZER	**
K0105	A9900	7639	IV POLE (K0105) ATTACH F/ W/C	**
E1399	A9900	7641	MECHANICAL SCALE (E1399) PEDIATRIC/NEONATAL	**
A7008	A9900	7661	NEBULIZER (A7008) KIT PREFILL W/STR H20 1L BAX	**
E1399	A9900	7663	O2 CONNECTOR (E1399) XXXX/IRRIGATION NOZZLE BAX	**
E1399	A9900	7615	O2 HUMIDIFIER (E1399) AQUA+NEONATAL EA HUD	**
E1399	A9900	7623	O2 SWIVEL (E1399) ADAPTER ANGLED STERILE	**
L8501	A9900	7624	SPEAKING VALVE (L8501) WHITE PAS	**
A4319	HH591	7629	STERILE WATER (A4319) F/IRRIG 1L BAX	**
A7001	HH591	7619	SUCTION BOTTLE (A7001) W/LID & TUBING	**
E1399	A9900	7616	SUCTION FILTER (E1399) BACTERIA	**
A6265	HH591	7628	TAPE ALL TYPES (A6265) EXCLUDING MICROFOAM, PER 18 SQ INCHES	**
A4481	A9900	7622	TRACH FILTER (A4481) BACTERIA ELECTROSTATIC	**
A4623	A9900	7618	TRACH INNER (A4623) CANNULA	**
A4621	A9900	7617	TRACH TUBE MASK (A4621) COLLAR OR HOLDER	**
A7010	A9900	7662	TUBING (A7010) AEROSOL CORRUGATED PER FOOT	**
E1399	A9900	7631	VENT ADAPTER (E1399) MDI HUD	**
A9900	A9900	7630	VENT BATTERY CHARGER (A9900) 12V GEL	**
E1399	A9900	7632	VENT CONNECTOR (E1399) PED OR ADULT OMNIFLEX DISP	**
E1399	A9900	7633	VENT FILTER (E1399) HYGROBAC S ELECTOSTATIC MAL	**
E1399	A9900	7634	VENT THERMOMETER (E1399) W/ ADAPTER	**
K0108	A9900	7638	W/C BRAKE EXTENSION (K0108) TIP BLK 10/PK	**
E1399	A9900	7635	XXXXXX BASKET (E1399) VINYL COATED	**
E0159	A9900	7640	XXXXXX BRAKE (E0159) ATTACHMENT	**
E0148	A9900	7636	XXXXXX HVY DUTY (E0148) FOLDING X-WIDE	**
E0149	A9900	7637	XXXXXX HVY DUTY (E0149) W/ WHEELS	**
E1399	A9900	7645	CPAP (E1399) DC BATTERY ADAPTER CABLE	**
E1399	A9900	7646	CPAP (E1399) EXHALATION PORT DISP	**
E1399	A9900	7647	CPAP (E1399) FUSE KIT INTERNATIONAL A/C	**
E1399	A9900	7648	CPAP (E1399) HUMIDIFIER CHAMBER KIT DISP	**
E1399	A9900	7649	CPAP (E1399) HUMIDIFIER CHAMBER REUSABLE	**
E1399	A9900	7650	CPAP (E1399) HUMIDIFIER MOUNTING TRAY	**
E1399	A9900	7651	CPAP (E1399) INVERTOR AC/DC	**
E1399	A9900	7652	CPAP (E1399) POWER CORD F/ARIA-SYNC	**
E1399	A9900	7653	CPAP (E1399) SHELL W/O PRESSURE TAP	**
A9900	DM590	7566	CPAP CALIBRATION SHELL (A9900)	**
A9900	DM590	7565	CPAP SHORT TUBING (A9900)	**
E0601	E0601	7690	VENT, CONTINUOUS POSITIVE (E0500) AIRWAY PRESSURE DEVICE	N/A	**
E0452	E0452	7691	VENT, BILEVEL INTERMITTENT (E0500) ASSIST DEVICE (BIPAP)	N/A	**

The following items were added in 2002
E0747	DM570	6875	STIMULATOR, OSTEOGENIC, ULTRASOUND	**
A9900	A9900	7695	GEL/SILICON GOLD SEAL CPAP/BIPAP MASK (A9900)	**
A9900	A9900	7701	VENT THERAPEUTIC ST BIPAP W/ BACKUP RATE (K0533)	N/A	**
A9900	A9900	7703	O2 SYS HELIOS PORT LIQUID, RENT (E1399)		COST+10%
HH591	HH591	7704	PUMP, EXT INFUSION, XXXX DIABECARE, INSULIN (E0784)	COST+10%
E0784	E0784	7731	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	**
A9900	A9900	7737	CPAP DREAM SEAL INTERFACE FOR USE WITH BREEZE MASK (A9900)	COST+10%
DM590	DM590	7738	CPAP CHIN STRAP DELUXE (K0186)	COST+10%
E1340	E1340	7768	W/C REPAIRS - CUSTOM (E1340)	COST+10%

The following may be charged under extraordinary circumstances:
E1399	E1399	4551	LABOR/SERVICE/SHIPPING CHARGES	COST+10%
E1399	E1399	2731	SHIPPING AND HANDLING FEES	COST+10%

The following may be charged if over and above routine on rental equipment:
E1350	E1350	2382	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	COST+10%
E1340	E1340	2554	W/C REPAIRS - STANDARD (E1340)	COST+10%
E1399	E1399	4552	MISCELLANEOUS SUPPLIES	COST+10%		COST+10%
E1399	E1399	2589	REPAIR (E1399), RESPIRATORY EQUIPMENT	COST+10%
E1399	E1399	4561	RESPIRATORY SUPPLIES (A4618)	COST+10%		COST+10%
E1399	E1399	4549	TENS/APNEA SUPPLIES	COST+10%		COST+10%

NOTES:

1.   Whether rental or purchase, rates include all shipping, labor and set-up.

2.   If item is rented, rates include all supplies to enable the equipment to function effectively, with the exception of supplies for CPAP, BIPAP, Ventilators, Suction, Enteral Pumps and CPM.  Such exception supplies will be billed at cost plus 10%.

3.   If item is rented, rates include repair and maintenance costs.

4.   If item is purchased, supplies, repair and maintenance will be billed at cost plus 10%.

5.   All equipment not listed above will be billed at cost plus 10% until rates are mutually established and become part of the fee schedule.

6.   Rates effective through 12/31/2003.

** Confidential Treatment Requested