ATTACHMENT H

	Attachment H is a table displaying the contracted rates by rate cell for each contracted region.						These rates will be the basis for calculating capitation payments in each contracted Region.
		Contracted Rates by Region
	CMO NAME		Amerigroup
	Rate Category		Atlanta		North			East		Southeast		Southwest
LIM/RSM/Refugee
		0 - 2 Months Male & Female	$	1,104.24	$	1,152.84		$	1,049.52	$	1,126.52	$	1,110.28
		3 - 11 Months Male & Female	$	177.85	$	217.40		$	202.50	$	247.21	$	227.72
		1 - 5 Years Male & Female	$	106.42	$	129.93		$	114.88	$	139.89	$	150.95
		6 - 13 Years Male & Female	$	110.25	$	131.63		$	108.55	$	123.22	$	125.95
		14 - 20 Years Female	$	166.58	$	220.61		$	191.56	$	216.47	$	186.23
		14 - 20 Years Male	$	129.78	$	156.49		$	112.19	$	129.16	$	119.13
		21 - 44 Years Female	$	227.50	$	295.81		$	255.36	$	291.88	$	280.71
		21 - 44 Years Male	$	255.65	$	372.11		$	293.03	$	340.18	$	315.01
		45+ Years Female	$	388.74	$	493.45		$	429.41	$	522.44	$	498.66
		45+ Years Male	$	481.46	$	561.93		$	561.93	$	642.74	$	566.68
PeachCare
		0 - 2 Months Male & Female	$	202.95	$	204.30		$	205.49	$	213.07	$	203.45
		3 - 11 Months Male & Female	$	181.55	$	188.84		$	188.84	$	190.06	$	190.06
		1 - 5 Years Male & Female	$	109.87	$	132.55		$	121.21	$	154.62	$	165.91
		6 - 13 Years Male & Female	$	131.20	$	148.90		$	132.76	$	154.48	$	152.27
		14 - 20 Years Female	$	156.06	$	190.61		$	167.59	$	186.58	$	182.59
		14 - 20 Years Male	$	144.31	$	166.05		$	138.84	$	158.00	$	151.26
Female Services
Breast and Cervical Cancer			$	1,544.70	$	1,623.60		$	1,623.60	$	1,637.93	$	1,637.93
Maternity and Delivery Services			Unit Cost		Unit Cost			Unit Cost		Unit Cost		Unit Cost
Kick Payment			$	5,796.63	$	5,774.93		$	5,821.47	$	5,846.21	$	5,709.09