| TILE | TILE base rate |
| 201 | $164.43 |
| 202 | $146.72 |
| 203 | $138.84 |
| 204 | $116.13 |
| 205 | $107.87 |
| 206 | $109.08 |
| 207 | $99.10 |
| 208 | $95.75 |
| 209 | $89.34 |
| 210 | $77.87 |
| 211 | $75.06 |
| 212 (default) | $75.06 |
| Supplemental Payments: | |
| Ventilator - Continuous | $88.77 |
| Ventilator - Less than Continuous | $35.51 |
| Pediatric Tracheostomy | $53.26 |