Provider Rate Setting

Community Care coordinates provider rate requests across our HealthChoices networks in Pennsylvania. To submit a rate request, providers should review our rate setting policy, ADM017 Provider Rate Setting All Contracts (Except HealthChoices Northeast). This policy explains the timeline for submission and decisions of rate increase requests, as well as giving providers guidance on what information should be included in requests. This policy does not prohibit Community Care from making rate adjustments throughout the year, as needed. All rate increase requests should be submitted to your Community Care Provider Relations Representative.

If you are interested in submitting a rate increase request for HealthChoices Northeast, please see the NBHCC policy revised 09/09/2009.