Interstate TRS Fund 2017 Intrastate Rate and Minute Data

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Overview

Rate and Demand
Add. Costs Paid to Provider
Contact

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Sheet 1: Rate and Demand

Interstate TRS Fund
2017 Intrastate Rate and Minute Data for MARS Methodology
Jurisdiction			Prepared By		Telephone		Email Address
					Actual Intrastate Per Minute Compensation Rates		Number of Intrastate Minutes
Report data for calendar year 2017
Fill in the state abbreviation above, service type and provider name. Once all three are entered, this will fill in automatically. Jurisdiction	Service Type	Provider	Rate Start Date	Rate End Date	Conversation	Session	Conversation	Session

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Sheet 2: Add. Costs Paid to Provider

Interstate TRS Fund
Additional Costs Paid to Provider for Calendar Year 2017
Jurisdiction	Service Type	Provider	Rate Start Date	Rate End Date	Amount	Description

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Sheet 3: Contact

DRAFT - NOT FOR PUBLIC USE
Not Approved by OMB
2017 Version
OMB Control number XXXX-XXXX
See instructions for public burden estimate
If you have questions about the content of these forms, please contact:							Bob Loube		[email protected]		301-681-0338
Please send this completed workbook by February 20, 2018 to:									[email protected]		717-585-6605