Sliding Fee Scale – Hopewell Center

Sliding Fee	A (0-100% of FPL)	B (101-135% of FPL)	C (136 – 165% of FPL)	D (166-200% of FPL)
Family Size	Monthly / Yearly	Monthly / Yearly	Monthly / Yearly	Monthly / Yearly
1	$0 – $1073 / $0 – 12880	$1074 – $1449 / $12881 – $17388	$1450 – $1771 / $17389 – $21252	$1722 – $2147 / $21253 – $25760
2	$0 – $1452 / $0 – $17420	$1453 – $1960 / $17421 – $23517	$1961 – $2395 / $23518 – $28743	$2396 – $2903 / $28744 – $34840
3	$0 – 1830 / $0 – 21960	$1831 – $2471 / $21961 – $29646	$2472 – $3020 / $29647 – $36234	$3021 – $3660 / $36235 – $43920
4	$0 – $2208 / $0 – 26500	$2209 – $2981 / $26501 – $35775	$2982 – $3644 / $35776 – $43725	$3645 – $4417 / $43726 – $53000
5	$0 – $2587 / $0 – $31040	$2588 – $3492 / $31041 – $41904	$3493 – $4268 / $41905 / $51216	$4269 – $5173 / $51217 – $62080
6	$0 – $2965 / $0 – $35580	$2966 – $4003 / $35581 – $48033	$4004 – $4892 / $48034 – $58707	$4893 – $5930 / $58708 – $71160
7	$0 – $3343 / $0 – $40120	$3344 – $4514 / $40121 – $54162	$4515 – $5517 / $54163 – $66198	$5518 – $6687 / $66199 – $80240
8	$0 – $3722 / $0 – $44660	$3723 – $5024 / $44661 – $60291	$5025 – $6141 / $60292 – $73689	$6142 – $7443 / $73690 – $89320
Each Additional Person	$378 / $4540	$511 / $4541 – $6129	$624 / $6130 – 7491	$757 / $7492 – $9080

Service Provided	A	B	C	D	Full Fee (FF)	Same Day Fee (SDF)
General Therapy/Psych	$30	$40	$50	$60	$132-263 (varies)	$70
Group Therapy	$10	$20	$30	$40	$52	$45
Psychiatric Evaluation	$60	$80	$100	$120	$303	$140
Psychological Testing	$30	$40	$50	$60	$204	$70
Adult EIP (4 Week Program)	$40	$64	$80	$104	$240	$180
Early Intervention Screening	$10	$16	$20	$26	$60	$145
SUD Residential Adult *Per Day Rate	$40	$64	$84	$102	$730	$143
SUD Partial Hospitalization	$33	$53	$69	$84	$206	$118
SUD Outpatient	$26	$37	$46	$55	$145	$77
Medication Management	$30	$40	$50	$60	$204	$70

Gráfico de determinación de categoría de tarifa deslizante
En vigor hasta enero 31^st, 2022 (o actualizado por el Departamento de Salud y Servicios Humanos)

tarifa móvil	A (0-100% of FPL)	B (101-135% of FPL)	C (136 – 165% of FPL)	D (166-200% of FPL)
tamaño de la familia	Mensual / Anual	Mensual / Anual	Mensual / Anual	Mensual / Anual
1	$0 – $1073 / $0 – 12880	$1074 – $1449 / $12881 – $17388	$1450 – $1771 / $17389 – $21252	$1722 – $2147 / $21253 – $25760
2	$0 – $1452 / $0 – $17420	$1453 – $1960 / $17421 – $23517	$1961 – $2395 / $23518 – $28743	$2396 – $2903 / $28744 – $34840
3	$0 – 1830 / $0 – 21960	$1831 – $2471 / $21961 – $29646	$2472 – $3020 / $29647 – $36234	$3021 – $3660 / $36235 – $43920
4	$0 – $2208 / $0 – 26500	$2209 – $2981 / $26501 – $35775	$2982 – $3644 / $35776 – $43725	$3645 – $4417 / $43726 – $53000
5	$0 – $2587 / $0 – $31040	$2588 – $3492 / $31041 – $41904	$3493 – $4268 / $41905 / $51216	$4269 – $5173 / $51217 – $62080
6	$0 – $2965 / $0 – $35580	$2966 – $4003 / $35581 – $48033	$4004 – $4892 / $48034 – $58707	$4893 – $5930 / $58708 – $71160
7	$0 – $3343 / $0 – $40120	$3344 – $4514 / $40121 – $54162	$4515 – $5517 / $54163 – $66198	$5518 – $6687 / $66199 – $80240
8	$0 – $3722 / $0 – $44660	$3723 – $5024 / $44661 – $60291	$5025 – $6141 / $60292 – $73689	$6142 – $7443 / $73690 – $89320
Cada persona adicional	$378 / $4540	$511 / $4541 – $6129	$624 / $6130 – 7491	$757 / $7492 – $9080

Servicios prestados	A	B	C	D	Tarifa completa	tarifa del mismo día
terapia general	$30	$40	$50	$60	$132-263 (varia)	$70
terapia de grupo	$10	$20	$30	$40	$52	$45
evaluación psiquiátrica	$60	$80	$100	$120	$303	$140
pruebas psicológicas	$30	$40	$50	$60	$204	$70
EIP adulto (4 semanas )	$40	$64	$80	$104	$240	$180
cribado de intervención temprana	$10	$16	$20	$26	$60	$145
SUD adulto residencial *tarifa por día	$40	$64	$84	$102	$730	$143
SUD hospitalización parcial	$33	$53	$69	$84	$206	$118
SUD paciente externo	$26	$37	$46	$55	$145	$77
manejo de medicamentos	$30	$40	$50	$60	$204	$70

SUD- trastorno por uso de sustancias IEP- programa de educación individualizada $- dólares