inpatient ratio of cost to charges effective 10/1/2016 · 121789503 1821009242 adventist health...

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip County Rate Effective Date Inpatient Rate (October) 150260101 1093709222 ABILENE PSYCHIATRIC CENTER INC 4225 WOODS PLACE ABILENE, TX 79602-7991 TAYLOR 09/01/2006 37% 112705203 1851344162 ABILENE REGIONAL MEDICAL CENTER 6250 US HIGHWAY 83 # 84 ABILENE, TX 79606-5215 TAYLOR 09/01/2016 15% 205404101 1740331693 ACADIA ABILENE LLC- 4225 WOODS PL ABILENE, TX 79602-7991 TAYLOR 01/01/2007 37% 203965301 1235392192 ACUITY HOSPITAL OF SOUTH TEXAS LLC 718 LEXINGTON AVE SAN ANTONIO, TX 78212-4768 BEXAR 05/24/2008 63% 121789503 1821009242 ADVENTIST HEALTH SYSTEM SUNBELT INC-CENTRAL TEXASMEDIC 1301 WONDER WORLD DR SAN MARCOS, TX 78666-7533 HAYS 04/01/2016 36% 175925003 1386691046 ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW 2601 DIMMITT RD STE 400 PLAINVIEW, TX 79072-1833 HALE 03/03/2005 80% 175925003 1386691046 ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW 2601 DIMMITT RD STE 400 PLAINVIEW, TX 79072-1833 HALE 03/03/2005 80% 212487701 1568600195 ALLEGIANCE HEALTH CENTER OF MIDLAND LLC 207 TRADEWINDS BLVD MIDLAND, TX 79706-2807 MIDLAND 04/01/2013 80% 198956801 1497925267 ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE LLC 1612 S HENDERSON BLVD KILGORE, TX 75662-3518 GREGG 12/01/2014 42% 195253301 1366506826 AMERICAN LEGION HOSPITAL 1305 CROWLEY-RAYNE HWY CROWLEY, LA 70526-8202 OUTOFSTATE 09/12/2008 50% 282322101 1407169196 AMH CATH LABS, LLC-TEXAS HEALTH HEART & VASCULAR HOSPITA 811 WRIGHT ST ARLINGTON, TX 76012-4708 TARRANT 01/01/2016 26% 127298107 1174563779 ANDREWS COUNTY HOSPITAL DISTRICT 720 HOSPITAL DR ANDREWS, TX 79714-3617 ANDREWS 09/01/2016 100% 121805903 1669567715 ANGLETON DANBURY HOSPITAL DISTRICT-ANGLETON DANBURY M 132 E HOSPITAL DR ANGLETON, TX 77515-4112 BRAZORIA 09/01/2014 57% 094104901 1457393571 ANSON GENERALHOSPITAL-ANSON GENERAL HOSPITAL 101 AVENUE J ANSON, TX 79501 JONES 04/01/2016 69% 334284201 1295173664 ARISE HEALTHCARE SYSTEM, LLC- 3003 BEE CAVES RD AUSTIN, TX 78746-5542 TRAVIS 03/01/2016 24% 314665605 1093955296 ASPIRE HOSPITAL, LLC- 2006 S LOOP 336 W STE 500 CONROE, TX 77304-3315 MONTGOMERY 09/01/2011 50% 133255305 1073600136 ATLANTA HOSPITAL AUTHORITY-ATLANTA MEMORIAL HOSPITAL 1007 S WILLIAM ST ATLANTA, TX 75551-3245 CASS 01/01/2014 59% 282268601 1386882488 ATRIUM MEDICAL CENTER LP- 11929 W AIRPORT BLVD STE 110 STAFFORD, TX 77477-2454 FORT BEND 07/01/2016 45% 339420701 1306146733 AUDUBON BEHAVIORAL HEALTHCARE OF LONGVIEW LLC- 615 CLINIC DR LONGVIEW, TX 75605-5172 GREGG 03/22/2012 50% 348183001 1144625153 AUSTIN BEHAVIORAL HOSPITAL, LLC-CROSS CREEK HOSPITAL 8402 CROSS PARK DR AUSTIN, TX 78754-4595 TRAVIS 04/22/2015 50% 094215302 1245292630 AUSTIN CENTER FOR OUTPATIENT SURGERY LP-NORTHWEST HIL 6818 AUSTIN CTR BLVD #100 AUSTIN, TX 78731-3199 TRAVIS 02/01/2014 16% 021194801 1326052226 AUSTIN STATE HOSPITAL 4110 GUADALUPE ST AUSTIN, TX 78751-4223 TRAVIS 06/01/2006 97% 130089906 1225038938 BALLINGER MEMORIAL HOSPITAL 608 AVENUE B BALLINGER, TX 76821-2406 RUNNELS 10/01/2016 96% 094148602 1093744187 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN 3080 COLLEGE BEAUMONT, TX 77704-4606 JEFFERSON 09/01/2015 28% 094148602 1093744187 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN 3080 COLLEGE BEAUMONT, TX 77704-4606 JEFFERSON 11/01/2016 27% 136488705 1295764330 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN 608 STRICKLAND ORANGE, TX 77630-4717 ORANGE 08/01/2016 40% 214757101 1871739714 BASIN HEALTHCARE CENTER- 900 E 4TH ST ODESSA, TX 79761-5255 ECTOR 02/01/2016 42% 208397401 1881823151 BASTROP BLACKHAWK LLC-LAKESIDE HOSPITAL AT BASTROP 3201 HIGHWAY 71 E BASTROP, TX 78602-5126 BASTROP 01/01/2011 45% 020973601 1508810573 BAY AREA HEALTHCARE GROUP, LTD-CORPUS CHRISTI MEDICAL C 7101 S PADRE ISLAND DR CORPUS CHRISTI, TX 78412-4913 NUECES 09/01/2016 15% 341698401 1336574904 BAY AREA REGIONAL MEDICAL CENTER LLC- 200 BLOSSOM ST WEBSTER, TX 77598-4204 HARRIS 08/01/2016 46% 135036506 1669472387 BAYLOR ALL SAINTS MEDICAL CENTER-BAYLOR SCOTT & WHITE AL 1400 8TH AVE FORT WORTH, TX 76104-4110 TARRANT 10/01/2016 41% 138353107 1194893263 BAYLOR COUNTY HOSPITAL DISTRICT-SEYMOUR HOSPITAL 200 STADIUM DRIVE SEYMOUR, TX 76380-2344 BAYLOR 07/01/2016 100% 151691601 1609855139 BAYLOR HEART AND VASCULAR HOSPITAL 621 N HALL STREET DALLAS, TX 75226-2017 DALLAS 07/01/2016 43% 288563403 1285930891 BAYLOR INSTITUTE FOR REHABILITATION AT FRISCO- 500 BROAD ST WICHITA FALLS, TX 76301-3109 WICHITA 04/01/2011 50% 127262703 1073511762 BAYLOR MED CTR AT GRAPEVINE-BAYLOR SCOTT AND WHITE MED 1650 W COLLEGE ST GRAPEVINE, TX 76051-3565 TARRANT 08/01/2015 39% 344925801 1952509465 BAYLOR MEDICAL CENTER AT CARROLLTON-BAYLOR SCOTT & WH 4343 N JOSEY LN CARROLLTON, TX 75010-4603 DENTON 10/01/2016 47% 121776205 1992700983 BAYLOR MEDICAL CENTER AT IRVING- 1901 N MACARTHUR BLVD IRVING, TX 75061 DALLAS 08/01/2015 37% 135223905 1265430177 BAYLOR MEDICAL CENTER AT WAXAHACHIE 2400 N INTERSTATE HIGHWAY 35 E WAXAHACHIE, TX 75165-5240 ELLIS 05/01/2016 46% 314161601 1124305065 BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY-BAYLOR 5252 W UNIVERSITY DR MCKINNEY, TX 75071-7822 COLLIN 08/01/2016 53% 171848805 1649273434 BAYLOR REGIONAL MEDICAL CENTER AT PLANO- 4700 ALLIANCE BLVD PLANO, TX 75093-5323 COLLIN 02/01/2016 36% 021003101 1851399406 BAYLOR SPECIALTY HOSPITAL 3504 SWISS AVE DALLAS, TX 75204-6224 DALLAS 07/01/2015 100% 139485012 1447250253 BAYLOR UNIVERSITY MEDICAL CENTER 3500 GASTON AVE DALLAS, TX 75246-2017 DALLAS 07/01/2016 38% 020993401 1174522494 BAYSIDE COMMUNITY HOSPITAL- 200 HOSPITAL DRIVE ANAHUAC, TX 77514-0398 CHAMBERS 11/01/2015 100% 199515101 1538317045 BCA OF TEXAS LLC-BCA PERMIAN BASIN 3300 S FM 1788 MIDLAND, TX 79706-2601 MIDLAND 03/12/2009 80% 182034201 1962486803 BEAUMONT BONE & JOINT INSTITUTE 3650 LAUREL ST BEAUMONT, TX 77707-2216 JEFFERSON 11/09/2005 50% 336658501 1396184180 BEHAVIORAL HEALTH CENTER OF THE PERMIAN BASIN LLC-OCEAN 3300 S FM 1788 MIDLAND, TX 79706-2601 MIDLAND 12/20/2012 50% 217547301 1093021719 BEHAVIORAL HEALTH MANAGEMENT, LLC- 5314 DASHWOOD DR STE 200 HOUSTON, TX 77081-4603 HARRIS 08/18/2010 80% 083290905 1477857332 BELLVILLE ST JOSEPH HEALTH CENTER-BELLVILLE GENERAL HOSP 44 N CUMMINGS ST BELLVILLE, TX 77418-1347 AUSTIN 07/01/2016 100% 136141205 1821011248 BEXAR COUNTY HOSPITAL DISTRICT-UNIVERSITY HEALTH SYSTEM 4502 MEDICAL DR SAN ANTONIO, TX 78229-4493 BEXAR 05/01/2016 39% Inpatient Ratio of Cost to Charges Effective 10/1/2016 Created by HHSC Rate Analysis Division 1 11/16/2016

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Page 1: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

150260101 1093709222 ABILENE PSYCHIATRIC CENTER INC 4225 WOODS PLACE ABILENE, TX 79602-7991 TAYLOR 09/01/2006 37%

112705203 1851344162 ABILENE REGIONAL MEDICAL CENTER 6250 US HIGHWAY 83 # 84 ABILENE, TX 79606-5215 TAYLOR 09/01/2016 15%

205404101 1740331693 ACADIA ABILENE LLC- 4225 WOODS PL ABILENE, TX 79602-7991 TAYLOR 01/01/2007 37%

203965301 1235392192 ACUITY HOSPITAL OF SOUTH TEXAS LLC 718 LEXINGTON AVE SAN ANTONIO, TX 78212-4768 BEXAR 05/24/2008 63%

121789503 1821009242 ADVENTIST HEALTH SYSTEM SUNBELT INC-CENTRAL TEXASMEDICAL CENTER 1301 WONDER WORLD DR SAN MARCOS, TX 78666-7533 HAYS 04/01/2016 36%

175925003 1386691046 ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW 2601 DIMMITT RD STE 400 PLAINVIEW, TX 79072-1833 HALE 03/03/2005 80%

175925003 1386691046 ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW 2601 DIMMITT RD STE 400 PLAINVIEW, TX 79072-1833 HALE 03/03/2005 80%

212487701 1568600195 ALLEGIANCE HEALTH CENTER OF MIDLAND LLC 207 TRADEWINDS BLVD MIDLAND, TX 79706-2807 MIDLAND 04/01/2013 80%

198956801 1497925267 ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE LLC 1612 S HENDERSON BLVD KILGORE, TX 75662-3518 GREGG 12/01/2014 42%

195253301 1366506826 AMERICAN LEGION HOSPITAL 1305 CROWLEY-RAYNE HWY CROWLEY, LA 70526-8202 OUTOFSTATE 09/12/2008 50%

282322101 1407169196 AMH CATH LABS, LLC-TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON 811 WRIGHT ST ARLINGTON, TX 76012-4708 TARRANT 01/01/2016 26%

127298107 1174563779 ANDREWS COUNTY HOSPITAL DISTRICT 720 HOSPITAL DR ANDREWS, TX 79714-3617 ANDREWS 09/01/2016 100%

121805903 1669567715 ANGLETON DANBURY HOSPITAL DISTRICT-ANGLETON DANBURY MEDICAL CENTER 132 E HOSPITAL DR ANGLETON, TX 77515-4112 BRAZORIA 09/01/2014 57%

094104901 1457393571 ANSON GENERALHOSPITAL-ANSON GENERAL HOSPITAL 101 AVENUE J ANSON, TX 79501 JONES 04/01/2016 69%

334284201 1295173664 ARISE HEALTHCARE SYSTEM, LLC- 3003 BEE CAVES RD AUSTIN, TX 78746-5542 TRAVIS 03/01/2016 24%

314665605 1093955296 ASPIRE HOSPITAL, LLC- 2006 S LOOP 336 W STE 500 CONROE, TX 77304-3315 MONTGOMERY 09/01/2011 50%

133255305 1073600136 ATLANTA HOSPITAL AUTHORITY-ATLANTA MEMORIAL HOSPITAL 1007 S WILLIAM ST ATLANTA, TX 75551-3245 CASS 01/01/2014 59%

282268601 1386882488 ATRIUM MEDICAL CENTER LP- 11929 W AIRPORT BLVD STE 110 STAFFORD, TX 77477-2454 FORT BEND 07/01/2016 45%

339420701 1306146733 AUDUBON BEHAVIORAL HEALTHCARE OF LONGVIEW LLC- 615 CLINIC DR LONGVIEW, TX 75605-5172 GREGG 03/22/2012 50%

348183001 1144625153 AUSTIN BEHAVIORAL HOSPITAL, LLC-CROSS CREEK HOSPITAL 8402 CROSS PARK DR AUSTIN, TX 78754-4595 TRAVIS 04/22/2015 50%

094215302 1245292630 AUSTIN CENTER FOR OUTPATIENT SURGERY LP-NORTHWEST HILLS SURGICAL HOSPITAL 6818 AUSTIN CTR BLVD #100 AUSTIN, TX 78731-3199 TRAVIS 02/01/2014 16%

021194801 1326052226 AUSTIN STATE HOSPITAL 4110 GUADALUPE ST AUSTIN, TX 78751-4223 TRAVIS 06/01/2006 97%

130089906 1225038938 BALLINGER MEMORIAL HOSPITAL 608 AVENUE B BALLINGER, TX 76821-2406 RUNNELS 10/01/2016 96%

094148602 1093744187 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN BAPTIST BEAUMONT HOSPITAL 3080 COLLEGE BEAUMONT, TX 77704-4606 JEFFERSON 09/01/2015 28%

094148602 1093744187 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN BAPTIST BEAUMONT HOSPITAL 3080 COLLEGE BEAUMONT, TX 77704-4606 JEFFERSON 11/01/2016 27%

136488705 1295764330 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN BAPTIST ORANGE HOSPITAL 608 STRICKLAND ORANGE, TX 77630-4717 ORANGE 08/01/2016 40%

214757101 1871739714 BASIN HEALTHCARE CENTER- 900 E 4TH ST ODESSA, TX 79761-5255 ECTOR 02/01/2016 42%

208397401 1881823151 BASTROP BLACKHAWK LLC-LAKESIDE HOSPITAL AT BASTROP 3201 HIGHWAY 71 E BASTROP, TX 78602-5126 BASTROP 01/01/2011 45%

020973601 1508810573 BAY AREA HEALTHCARE GROUP, LTD-CORPUS CHRISTI MEDICAL CENTER 7101 S PADRE ISLAND DR CORPUS CHRISTI, TX 78412-4913 NUECES 09/01/2016 15%

341698401 1336574904 BAY AREA REGIONAL MEDICAL CENTER LLC- 200 BLOSSOM ST WEBSTER, TX 77598-4204 HARRIS 08/01/2016 46%

135036506 1669472387 BAYLOR ALL SAINTS MEDICAL CENTER-BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER FOR1400 8TH AVE FORT WORTH, TX 76104-4110 TARRANT 10/01/2016 41%

138353107 1194893263 BAYLOR COUNTY HOSPITAL DISTRICT-SEYMOUR HOSPITAL 200 STADIUM DRIVE SEYMOUR, TX 76380-2344 BAYLOR 07/01/2016 100%

151691601 1609855139 BAYLOR HEART AND VASCULAR HOSPITAL 621 N HALL STREET DALLAS, TX 75226-2017 DALLAS 07/01/2016 43%

288563403 1285930891 BAYLOR INSTITUTE FOR REHABILITATION AT FRISCO- 500 BROAD ST WICHITA FALLS, TX 76301-3109 WICHITA 04/01/2011 50%

127262703 1073511762 BAYLOR MED CTR AT GRAPEVINE-BAYLOR SCOTT AND WHITE MEDICAL CENTER-GRAPEVINE 1650 W COLLEGE ST GRAPEVINE, TX 76051-3565 TARRANT 08/01/2015 39%

344925801 1952509465 BAYLOR MEDICAL CENTER AT CARROLLTON-BAYLOR SCOTT & WHITE MEDICAL CENTER -CARROLLTON 4343 N JOSEY LN CARROLLTON, TX 75010-4603 DENTON 10/01/2016 47%

121776205 1992700983 BAYLOR MEDICAL CENTER AT IRVING- 1901 N MACARTHUR BLVD IRVING, TX 75061 DALLAS 08/01/2015 37%

135223905 1265430177 BAYLOR MEDICAL CENTER AT WAXAHACHIE 2400 N INTERSTATE HIGHWAY 35 E WAXAHACHIE, TX 75165-5240 ELLIS 05/01/2016 46%

314161601 1124305065 BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY-BAYLOR SCOTT AND WHITE MEDICAL CENTER - MCKINNEY 5252 W UNIVERSITY DR MCKINNEY, TX 75071-7822 COLLIN 08/01/2016 53%

171848805 1649273434 BAYLOR REGIONAL MEDICAL CENTER AT PLANO- 4700 ALLIANCE BLVD PLANO, TX 75093-5323 COLLIN 02/01/2016 36%

021003101 1851399406 BAYLOR SPECIALTY HOSPITAL 3504 SWISS AVE DALLAS, TX 75204-6224 DALLAS 07/01/2015 100%

139485012 1447250253 BAYLOR UNIVERSITY MEDICAL CENTER 3500 GASTON AVE DALLAS, TX 75246-2017 DALLAS 07/01/2016 38%

020993401 1174522494 BAYSIDE COMMUNITY HOSPITAL- 200 HOSPITAL DRIVE ANAHUAC, TX 77514-0398 CHAMBERS 11/01/2015 100%

199515101 1538317045 BCA OF TEXAS LLC-BCA PERMIAN BASIN 3300 S FM 1788 MIDLAND, TX 79706-2601 MIDLAND 03/12/2009 80%

182034201 1962486803 BEAUMONT BONE & JOINT INSTITUTE 3650 LAUREL ST BEAUMONT, TX 77707-2216 JEFFERSON 11/09/2005 50%

336658501 1396184180 BEHAVIORAL HEALTH CENTER OF THE PERMIAN BASIN LLC-OCEANS BEHAVIORAL HOSPITAL OF THE PERMIAN BASIN 3300 S FM 1788 MIDLAND, TX 79706-2601 MIDLAND 12/20/2012 50%

217547301 1093021719 BEHAVIORAL HEALTH MANAGEMENT, LLC- 5314 DASHWOOD DR STE 200 HOUSTON, TX 77081-4603 HARRIS 08/18/2010 80%

083290905 1477857332 BELLVILLE ST JOSEPH HEALTH CENTER-BELLVILLE GENERAL HOSPITAL 44 N CUMMINGS ST BELLVILLE, TX 77418-1347 AUSTIN 07/01/2016 100%

136141205 1821011248 BEXAR COUNTY HOSPITAL DISTRICT-UNIVERSITY HEALTH SYSTEM 4502 MEDICAL DR SAN ANTONIO, TX 78229-4493 BEXAR 05/01/2016 39%

Inpatient Ratio of Cost to Charges Effective 10/1/2016

Created by HHSC Rate Analysis Division 1 11/16/2016

Page 2: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

094224503 1356312243 BIG BEND REGIONAL MEDICAL CENTER 2600 N HIGHWAY 118 ALPINE, TX 79830-2002 BREWSTER 10/01/2016 36%

112721903 1538465901 BIR JV LLP-BAYLOR INSTITUTE FOR REHABILITATION 909 N WASHINGTON AVE DALLAS, TX 75246-1520 DALLAS 07/01/2014 78%

127305405 1417942608 BOWIE MEMORIAL HOSPITAL 705 E GREENWOOD AVE BOWIE, TX 76230-3135 MONTAGUE 10/01/2016 43%

094226002 1801817135 BRAZOS VALLEY PHYSICIANS ORGANIZATION MSO LLC-THE PHYSICIANS CENTRE HOSPITAL 3131 UNIVERSITY DR EAST BRYAN, TX 77802-3473 BRAZOS 12/01/2014 56%

191537303 1417979204 BRENTWOOD ACQUISITION SHREVEPORT INC-UNIVERSAL HEALTH SERVICES INC 1006 HIGHLAND AVE SHREVEPORT, LA 71101-4103 OUTOFSTATE 03/01/2004 80%

207311601 1114903523 BRIM HEALTHCARE OF TEXAS LLC-WADLEY REGIONAL MEDICAL CENTER 1000 PINE ST TEXARKANA, TX 75501-5100 BOWIE 01/01/2015 31%

020930601 1679526982 BROWNWOOD REGIONAL MEDICAL CENTER 1501 BURNET RD BROWNWOOD, TX 76801-8520 BROWN 10/01/2016 26%

322879301 1407191984 BSA HOSPITAL LLC DBA BAPTIST ST ANTHONYS HOSPITAL- 1600 WALLACE BLVD AMARILLO, TX 79106-1799 POTTER 04/01/2016 31%

362293801 1134127749 BT GARLAND JV LLP-BAYLOR SCOTT & WHITE MEDICAL CENTER - GARLAND 2300 MARIE CURIE DR GARLAND, TX 75042-5706 DALLAS 02/01/2016 35%

112725003 1750377289 BURLESON ST JOSEPH HEALTH CENTER-BURLESON ST. JOSEPH HEALTH CENTER 1101 WOODSON DRIVE CALDWELL, TX 77836-1052 BURLESON 01/01/2015 41%

212060201 1205164928 CAHRMC LLC-RICE MEDICAL CENTER 600 S AUSTIN RD EAGLE LAKE, TX 77434-3202 COLORADO 02/01/2016 100%

312666601 1295097624 CAMBRIDGE HOSPITAL, LLC- 7601 FANNIN ST HOUSTON, TX 77054-1905 HARRIS 11/26/2012 50%

314300001 1134401466 CARROLLTON SPRINGS LLC 2225 PARKER RD CARROLLTON, TX 75010-4711 DENTON 04/24/2012 50%

211970301 1013142553 CBSH,LLC- 6130 PARKWAY CORPUS CHRISTI, TX 78414-2455 NUECES 01/01/2016 26%

192622201 1376662296 CEDAR PARK REGIONAL MEDICAL CENTER 1401 MEDICAL PARKWAY CEDAR PARK, TX 78613-7464 WILLIAMSON 01/01/2016 22%

190809701 1609091693 CENTRAL TEXAS REHABILITATION HOSPITAL LLC-CENTRAL TEXAS REHABILITATION HOSPITAL 700 W 45TH ST AUSTIN, TX 78751-2800 TRAVIS 01/01/2016 100%

020817501 1174576698 CHCA BAYSHORE LP-BAYSHORE MEDICAL CENTER 4000 SPENCER HWY PASADENA, TX 77504-1202 HARRIS 01/01/2016 17%

121807504 1063466035 CHCA CLEAR LAKE LP-CLEAR LAKE REGIONAL MEDICAL CENTER 500 W MEDICAL CENTER BLVD WEBSTER, TX 77598-4220 HARRIS 01/01/2016 12%

020841501 1962455816 CHCA CONROE LP-CONROE REGIONAL MEDICAL CENTER 504 MEDICAL CENTER BLVD CONROE, TX 77305-2808 MONTGOMERY 08/01/2016 18%

349366001 1609275585 CHCA PEARLAND, LP-PEARLAND MEDICAL CENTER 11100 SHADOW CREEK PKWY PEARLAND, TX 77584-7285 BRAZORIA 03/17/2015 50%

094187402 1275580938 CHCA WEST HOUSTON LP-WEST HOUSTON MEDICAL CENTER 12141 RICHMOND AVE HOUSTON, TX 77082-2408 HARRIS 01/01/2016 23%

112712802 1023065794 CHCA WOMANS HOSPITAL LP-THE WOMANS HOSPITAL OF TEXAS 7600 FANNIN ST HOUSTON, TX 77054-1906 HARRIS 03/01/2016 10%

356438701 1912395203 CHG HOSPITAL AUSTIN LLC-CORNERSTONE HOSPITAL AUSTIN 4207 BURNET RD AUSTIN, TX 78756-3316 TRAVIS 07/15/2005 50%

357216601 1073901476 CHG HOSPITAL CONROE LLC-CHG HOSPITAL CONROE, LLC 1500 GRAND LAKE DR CONROE, TX 77304-2891 MONTGOMERY 09/01/2010 35%

358588701 1457730426 CHG HOSPITAL HOUSTON LLC-CORNERSTONE HOSPITAL HOUSTON-BELLAIRE 5314 DASHWOOD DR HOUSTON, TX 77081-0000 HARRIS 11/01/2010 7%

355796901 1760870166 CHG HOSPITAL MCALLEN LLC-SOLARA HOSPITAL MCALLEN 301 W EXPRESSWAY 83 FL 8 MCALLEN, TX 78503 HIDALGO 05/01/2011 23%

357053301 1659761815 CHG HOSPITAL MEDICAL CENTER LLC- 2001 HERMANN DR HOUSTON, TX 77004 HARRIS 01/12/2012 50%

293849001 1902164684 CHILDREN'S HOPE RESIDENTIAL SERVICES, INC.- 2402 CANYON LAKE DR LUBBOCK, TX 79415-2000 LUBBOCK 05/22/2011 50%

109196903 1164426896 CHILDRENS HOSPITAL OF PITTSBURGH 4401 PENN AVE PITTSBURGH, PA 15224-1334 OUTOFSTATE 04/12/2011 65%

138910807 1194743013 CHILDRENS MEDICAL CENTER OF DALLAS-CHILDRENS MEDICAL CENTER 1935 MEDICAL DISTRICT DR DALLAS, TX 75235-7701 DALLAS 10/01/2016 30%

354178101 1720480627 CHILDRENS MEDICAL CENTER OF DALLAS-CHILDREN'S MEDICAL CENTER PLANO 7601 PRESTON RD PLANO, TX 75024-3214 COLLIN 06/25/2015 50%

133250406 1326079534 CHILDRESS COUNTY HOSPITAL DISTRICT-CHILDRESS REGIONAL MEDICAL CENTER 901 US HIGHWAY 83 N CHILDRESS, TX 79201-2320 CHILDRESS 10/01/2016 43%

154632701 1548269590 CHILLICOTHE HOSPITAL DISTRICT 303 AVENUE I CHILLICOTHE, TX 79225-0370 HARDEMAN 10/01/2011 100%

127300503 1184622847 CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MED 6720 BERTNER AVE HOUSTON, TX 77030-2604 HARRIS 07/01/2016 29%

211454803 1548495740 CHRISTUS CONTINUING CARE- 820 CLARKSVILLE ST PARIS, TX 75460-6027 LAMAR 01/01/2015 50%

211468803 1932334125 CHRISTUS CONTINUING CARE- 2830 CALDER ST BEAUMONT, TX 77702-1809 JEFFERSON 07/01/2009 56%

211487801 1669607859 CHRISTUS CONTINUING CARE-CHRISTUS DUBUIS HOSPITAL OF HOUSTON 1919 LA BRANCH ST FL 7 GWS HOUSTON, TX 77002-8321 HARRIS 07/01/2009 50%

020976902 1295736734 CHRISTUS HEALTH ARK LATEX- 2600 SAINT MICHAEL DR TEXARKANA, TX 75503-5220 BOWIE 08/01/2015 26%

094353202 1467453902 CHRISTUS HEALTH ARK LA TEX-CHRISTUS ST MICHAEL REHABILITATION HOSPITAL 2400 ST MICHAEL DR TEXARKANA, TX 75503-2374 BOWIE 08/01/2015 31%

138296208 1679557888 CHRISTUS HEALTH SE TX-CHRISTUS HOSPITAL 2830 CALDER ST BEAUMONT, TX 77702-1809 JEFFERSON 07/01/2016 28%

112706003 1598749707 CHRISTUS JASPER MEMORIAL HOSPITAL- 1275 MARVIN HANCOCK DR JASPER, TX 75951-4935 JASPER 07/01/2016 46%

020844903 1821004151 CHRISTUS SANTA ROSA HEALTH CARE CORPORATION-CHILDRENS HOSPITAL OF SAN ANTONIO 333 N SANTA ROSA ST SAN ANTONIO, TX 78207-3108 BEXAR 07/01/2016 33%

020844901 1194787218 CHRISTUS SANTA ROSA HEALTH CARE CORPORATION-CHRISTUS SANTA ROSA HOSPITAL 2827 BABCOCK RD SAN ANTONIO, TX 78229 BEXAR 12/01/2015 35%

094222903 1003885641 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION- 2500 E MAIN ST ALICE, TX 78332-4261 JIM WELLS 07/01/2015 26%

020811801 1447228747 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL BEEVILLE 1500 E HOUSTON ST BEEVILLE, TX 78102-5312 BEE 07/01/2016 39%

121775403 1689641680 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI 2606 HOSPITAL BLVD CORPUS CHRISTI, TX 78405-1804 NUECES 07/01/2016 20%

136436606 1093783391 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL KLEBERG 1311 GENERAL CAVAZOS BLVD KINGSVILLE, TX 78363-7150 KLEBERG 07/01/2016 28%

315472601 1962786608 C & I HOLDINGS LLC-LONE STAR BEHAVORIAL HEALTH 16303 GRANT RD CYPRESS, TX 77429-1253 HARRIS 06/12/2012 50%

137907508 1124052162 CITIZENS MEDICAL CENTER COUNTY OF VICTORIA-CITIZENS MEDICAL CENTER 2701 HOSPITAL DRIVE VICTORIA, TX 77901-5748 VICTORIA 07/01/2016 39%

112742503 1326015595 CLARITY CHILD GUIDANCE CENTER-SOUTHWEST MENTAL HEALTH 8535 TOM SLICK SAN ANTONIO, TX 78229-3367 BEXAR 08/01/2015 53%

094138703 1437156361 CLAY COUNTY MEMORIAL HOSPITAL 310 W SOUTH ST HENRIETTA, TX 76365 CLAY 09/01/2016 100%

184632101 1972540532 CLEVELAND IMAGING & SURGICAL HOSPITAL LLC-DOCTORS DIAGNOSTIC HOSPITAL 1017 SOUTH TRAVIS CLEVELAND, TX 77327-5151 LIBERTY 01/01/2013 57%

137279905 1043281330 CLEVELAND REGIONAL MEDICAL CENTER LP-CLEVELAND REGIONAL MEDICAL CENTER 300 E CROCKETT ST CLEVELAND, TX 77327-4029 LIBERTY 03/01/2014 22%

094152803 1942314448 COCHRAN MEMORIAL HOSPITAL 201 E GRANT AVE MORTON, TX 79346-3444 COCHRAN 09/01/2008 90%

Created by HHSC Rate Analysis Division 2 11/16/2016

Page 3: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

020860501 1467403477 COLLEGE STATION MEDICAL CENTER 1604 ROCK PRAIRIE RD COLLEGE STATION, TX 77845-8395 BRAZOS 10/01/2016 17%

020943901 1689628984 COLUMBIA HOSPITAL MEDICAL CITY DALLAS, SUBSIDIARY-MEDICAL CITY DALLAS HOSPITAL 7777 FOREST LN DALLAS, TX 75230-2505 DALLAS 07/01/2016 12%

020950401 1134172406 COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP-MEDICAL CENTER OF ARLINGTON 3301 MATLOCK RD ARLINGTON, TX 76015-2998 TARRANT 06/01/2016 14%

111905902 1306897277 COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP-DENTON REGIONAL MEDICAL CENTER 3535 S I-35 E DENTON, TX 76210-6850 DENTON 01/01/2016 20%

112698903 1437102639 COLUMBIA MEDICAL CENTER OF MCKINNEY SUBSIDIARY LP-MEDICAL CENTER OF MCKINNEY 4500 MEDICAL CENTER DR MCKINNEY, TX 75069-1650 COLLIN 09/01/2016 17%

127311205 1699726406 COLUMBIA MEDICAL CENTER OF PLANO LP-MEDICAL CENTER OF PLANO 3901 W 15TH ST PLANO, TX 75075-7738 COLLIN 04/01/2016 16%

094105602 1518911833 COLUMBIA NORTH HILLS HOSPITAL-COLUMBIA NORTH HILLS HOSPITA 4401 BOOTH CALLOWAY ROAD N RICHLAND HILLS, TX 76180-7371 TARRANT 06/01/2016 23%

094193202 1659323772 COLUMBIA PLAZA MED CTR OF FT WORTH SUBSIDIARY LP-PLAZA MEDICAL CENTER OF FORT WORTH 900 8TH AVE FORT WORTH, TX 76104-3902 TARRANT 09/01/2016 16%

112716902 1619924719 COLUMBIA RIO GRANDE HEALTHCARE LP-RIO GRANDE REGIONAL HOSPITAL 101 E RIDGE RD MCALLEN, TX 78503-1847 HIDALGO 10/01/2016 13%

020947001 1043267701 COLUMBIA VALLEY HEALTHCARE SYSTEMS LP-VALLEY REGIONAL MEDICAL CENTER 100A E ALTON GLOOR BLVD BROWNSVILLE, TX 78521-3328 CAMERON 04/01/2016 12%

135033210 1740238641 COLUMBUS COMMUNITY HOSPITAL- 110 SHULT DR COLUMBUS, TX 78934-3016 COLORADO 05/01/2015 84%

281406304 1346544616 COMANCHE COUNTY MEDICAL CENTER COMPANY-COMANCHE COUNTY MEDICAL CENTER 10201 HIGHWAY 16 COMANCHE, TX 76442-4462 COMANCHE 10/01/2014 51%

112671602 1972581940 COMMUNITY HOSPITAL OF BRAZOSPORT-BRAZOSPORT REGIONAL HEALTH SYSTEM 100 MEDICAL DRIVE LAKE JACKSON, TX 77566-5674 BRAZORIA 01/01/2016 31%

091770005 1326025701 CONCHO COUNTY HOSPITAL 614 EAKER ST EDEN, TX 76837-0987 CONCHO 10/01/2016 100%

352064501 1588005888 CONTINUECARE HOSPITAL OF MIDLAND INC- 4214 ANDREWS HWY FL 3 MIDLAND, TX 79703-4822 MIDLAND 05/01/2014 50%

021184901 1891765178 COOK CHILDREN'S MEDICAL CENTER- 801 7TH AVE FORT WORTH, TX 76104-2733 TARRANT 10/01/2016 35%

196882804 1235299132 COOK CHILDRENS NORTHEAST HOSPITAL, LLC- 6316 PRECINCT LINE RD HURST, TX 76054-2766 TARRANT 01/01/2014 80%

130826407 1639176456 COON MEMORIAL HOSPITAL 1411 DENVER AVE DALHART, TX 79022-4809 DALLAM 08/01/2016 99%

313347201 1235374612 CORINTH INVESTOR HOLDINGS LLC- 3305 CORINTH PKWY CORINTH, TX 76208-5380 DENTON 12/01/2008 50%

094221102 1386652527 CORNERSTONE REGIONAL HOSPITAL 2302 CORNERSTONE BLVD EDINBURG, TX 78539-8471 HIDALGO 01/01/2016 31%

344945603 1821439183 CORPUS CHRISTI REHABILITATION HOSPITAL LLC 5726 ESPLANADE DR CORPUS CHRISTI, TX 78414-4165 NUECES 07/19/2013 50%

134772611 1780823021 CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY- 1507 W MAIN ST GATESVILLE, TX 76528-1024 CORYELL 08/01/2016 100%

137227806 1790702371 COUNTY OF YOAKUM-YOAKUM COUNTY HOSPITAL 412 MUSTANG AVE DENVER CITY, TX 79323-2750 YOAKUM 01/01/2016 100%

139461107 1972517365 COVENANT HEALTH SYSTEM-COVENANT MEDICAL CENTER 3615 19TH ST LUBBOCK, TX 79410-1225 LUBBOCK 07/01/2016 16%

319209801 1013941780 COVENANT LONG TERM CARE LP-COVENANT SPECIALTY HOSPITAL 3815 20TH ST LUBBOCK, TX 79410-1235 LUBBOCK 03/28/2007 50%

358006001 1518348747 COVENANT REHABILITATION HOSPITAL OF LUBBOCK LLC-TRUSTPOINT REHABILITATION HOSPITAL OF LUBBOCK 4302 PRINCETON ST LUBBOCK, TX 79415-1304 LUBBOCK 01/01/2016 41%

199602701 1316197767 CRANE COUNTY HOSPITAL DISTRICT-CRANE MEMORIAL HOSPITAL 1310 SOUTH ALFORD STREET CRANE, TX 79731-3809 CRANE 10/01/2016 100%

303478701 1407010622 CR EMERGENCY ROOM LLC-BAYLOR EMERGENCY MEDICAL CENTER 26791 HIGHWAY 380 AUBREY, TX 76227-7654 DENTON 10/17/2009 50%

094141105 1063500270 CROSBYTON CLINIC HOSPITAL 710 W MAIN ST CROSBYTON, TX 79322-2143 CROSBY 01/01/2016 83%

349808101 1104252030 CROSSROADS REGIONAL HOSPITAL,LLC DBA LONGLEAF HOSP- 44 VERSAILLES BLVD ALEXANDRIA, LA 71303-3960 OUTOFSTATE 09/01/2011 50%

138911619 1437148020 CUERO COMMUNITY HOSPITAL 2550 N ESPLANADE ST CUERO, TX 77954-4736 DEWITT 09/01/2015 79%

361949601 1568848059 CUMBERLAND SURGICAL HOSPITAL OF SAN ANTONIO LLC- 5330 N LOOP 1604 W SAN ANTONIO, TX 78249 BEXAR 01/23/2016 50%

021203701 1730187568 CYPRESS CREEK HOSPITAL INC 17750 CALI DR HOUSTON, TX 77090-2705 HARRIS 09/01/2006 51%

333289201 1457791105 DALLAS BEHAVIORAL HEALTHCARE HOSPITAL LLC- 800 KIRNWOOD DR DESOTO, TX 75115-2000 DALLAS 06/12/2012 50%

320384601 1356559991 DALLAS LTACH LLC- 8050 MEADOW RD DALLAS, TX 75231-3406 DALLAS 09/01/2013 50%

320384603 1356559991 DALLAS LTACH LLC-KINDRED HOSPITAL DALLAS CENTRAL 8050 MEADOW RD DALLAS, TX 75231-3406 DALLAS 09/01/2013 50%

219336901 1861690364 DALLAS MEDICAL CENTER LLC- 7 MEDICAL PKWY DALLAS, TX 75234-7823 DALLAS 01/01/2016 21%

189947801 1134108053 DAWSON COUNTY HOSPITAL DISTRICT-MEDICAL ARTS HOSPITAL 2200 N BRYAN AVE LAMESA, TX 79331-2451 DAWSON 04/01/2016 92%

160709501 1053317362 DAY SURGERY AT RENAISSANCE LLC-DOCTORS HOSPITAL AT RENAISSANCE LTD 5501 S MCCOLL RD EDINBURG, TX 78539-9152 HIDALGO 01/01/2016 20%

133544006 1568454403 DEAF SMITH COUNTY HOSPITAL DISTRICT-HEREFORD REGIONAL MEDICAL CENTER 540 W 15TH ST HEREFORD, TX 79045-2820 DEAF SMITH 10/01/2016 82%

343108201 1033204342 DENTON TRANSITIONAL LTCH LP-INTEGRITY TRANSITIONAL HOSPITAL 2813 S MAYHILL RD DENTON, TX 76208 DENTON 06/01/2008 50%

094118902 1851343909 DETAR HOSPITAL-DETAR HOSPITAL NAVARRO 506 E SAN ANTONIO ST VICTORIA, TX 77901-6060 VICTORIA 10/01/2016 16%

021214401 1235212895 DEVEREUX-TEXAS TREATMENT 1150 DEVEREUX DR LEAGUE CITY, TX 77573-2043 GALVESTON 04/01/2006 79%

094227802 1003939232 DICKERSON MEMORIAL HOSPITAL 1001 DICKERSON DR JASPER, TX 75951-5110 JASPER 05/01/2010 57%

217884001 1326134255 DIMMIT REGIONAL HOSPITAL 704 HOSPITAL DR CARRIZO SPRINGS, TX 78834-3836 DIMMIT 10/01/2016 51%

094194002 1699705426 DOCTORS HOSPITAL 9440 POPPY DRIVE DALLAS, TX 75218-3652 DALLAS 06/01/2016 19%

112727604 1891741468 DOCTORS HOSPITAL 1997 LP-DOCTORS HOSPITAL PARKWAY TIDWELL 510 W TIDWELL RD HOUSTON, TX 77091-4339 HARRIS 02/01/2016 43%

132812205 1548286172 DRISCOLL CHILDRENS HOSPITAL 3533 S ALAMEDA ST CORPUS CHRISTI, TX 78411-1721 NUECES 09/01/2016 28%

072521002 1992703540 DUKE UNIVERSITY HEALTH SYSTEM INC-DUKE UNIVERSITY HOSPITAL 2301 ERWIN RD DURHAM, NC 27710-0001 OUTOFSTATE 01/01/2008 60%

199210901 1669655601 EAST EL PASO PHYSICIANS MEDICAL CENTER LLC-FOUNDATION SURGICAL HOSPITAL OF EL PASO 1416 GEORGE DIETER DR EL PASO, TX 79936-7601 EL PASO 06/01/2016 25%

137074409 1689650921 EASTLAND MEMORIAL HOSPITAL DISTRICT-EASTLAND MEMORIAL HOSPITAL 304 S DAUGHERTY AVE EASTLAND, TX 76448-2609 EASTLAND 07/01/2016 50%

020812601 1235256884 EAST TEXAS MEDICAL CENTER 1000 S BECKHAM AVE TYLER, TX 75701-1908 SMITH 01/01/2016 11%

020812601 1235256884 EAST TEXAS MEDICAL CENTER 1000 S BECKHAM AVE TYLER, TX 75701-1908 SMITH 11/01/2016 11%

020812603 1619092780 EAST TEXAS MEDICAL CENTER 1000 S BECKHAM 5TH FLOOR TYLER, TX 75701-1908 SMITH 09/01/2006 31%

Created by HHSC Rate Analysis Division 3 11/16/2016

Page 4: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

139173209 1356320873 EAST TEXAS MEDICAL CENTER ATHENS 2000 S PALESTINE ST ATHENS, TX 75751-5610 HENDERSON 04/01/2016 18%

094127002 1801975107 EAST TEXAS MEDICAL CENTER CARTHAGE 409 COTTAGE RD CARTHAGE, TX 75633-1466 PANOLA 08/01/2016 22%

094190802 1578542098 EAST TEXAS MEDICAL CENTER FAIRFIELD 125 NEWMAN ST FAIRFIELD, TX 75840-1419 FREESTONE 08/01/2016 21%

208843701 1770717167 EAST TEXAS MEDICAL CENTER HENDERSON- 300 WILSON ST HENDERSON, TX 75652-5956 RUSK 10/01/2016 30%

130612806 1285689133 EAST TEXAS MEDICAL CENTER JACKSONVILLE 501 S RAGSDALE ST JACKSONVILLE, TX 75766-2434 CHEROKEE 02/01/2016 17%

130612806 1285689133 EAST TEXAS MEDICAL CENTER JACKSONVILLE 501 S RAGSDALE ST JACKSONVILLE, TX 75766-2434 CHEROKEE 11/01/2016 17%

136140407 1205821113 EAST TEXAS MEDICAL CENTER MOUNT VERNON-EAST TEXAS MEDICAL CENTER MT VERNON 500 SO STATE HWY 37 MOUNT VERNON, TX 75457-6550 FRANKLIN 07/01/2016 24%

138374715 1720037559 EAST TEXAS MEDICAL CENTER PITTSBURG- 2701 US HWY 271 N PITTSBURG, TX 75686-4289 CAMP 12/01/2015 29%

017624011 1396748430 EAST TEXAS MEDICAL CENTER QUITMAN- 117 N WINNSBORO ST QUITMAN, TX 75783-2144 WOOD 06/01/2016 54%

021177301 1700901873 EAST TEXAS MEDICAL CENTER RE 701 OLYMPIC PLAZA CIR TYLER, TX 75701-1950 SMITH 08/10/1995 80%

121817401 1821063553 EAST TEXAS MEDICAL CENTER TRINITY 317 PROSPECT DRIVE TRINITY, TX 75862-0317 TRINITY 03/01/2016 25%

348928801 1679903967 EBD BEMC BURLESON, LLC-BAYLOR EMERGENCY MEDICAL CENTER 12500 SOUTH FWY STE 100 BURLESON, TX 76028 JOHNSON 03/19/2015 50%

343799801 1952732653 EBD BEMC ROCKWALL, LLC-BAYLOR EMERGENCY MEDICAL CENTER 1975 ALPHA DR STE 100 ROCKWALL, TX 75087 ROCKWALL 10/01/2014 50%

135235306 1740273994 ECTOR COUNTY HOSPITAL DISTRICT-MEDICAL CENTER HOSPITAL 500 W 4TH ST ODESSA, TX 79761-5001 ECTOR 10/01/2016 38%

169893802 1780677971 ECTOR COUNTY HOSPITAL DISTRICT-MEDICAL CENTER HOSPITAL 500 W 4TH ST ODESSA, TX 79761-5001 ECTOR 06/01/2011 37%

311054601 1003192311 EL CAMPO MEMORIAL HOSPITAL- 303 SANDY CORNER RD EL CAMPO, TX 77437-9535 WHARTON 04/01/2016 100%

135034006 1811091903 ELECTRA HOSPITAL DISTRICT-ELECTRA MEMORIAL HOSPITAL 1207 S BAILEY ST ELECTRA, TX 76360-1112 WICHITA 11/01/2006 71%

135034009 1871583153 ELECTRA HOSPITAL DISTRICT-ELECTRA MEMORIAL HOSPITAL 1207 S BAILEY ST ELECTRA, TX 76360-3221 WICHITA 09/01/2016 61%

291854201 1558659714 EL PASO CHILDRENS HOSPITAL- 4845 ALAMEDA AVE EL PASO, TX 79905-2705 EL PASO 08/01/2014 50%

291854201 1558659714 EL PASO CHILDRENS HOSPITAL- 4845 ALAMEDA AVE EL PASO, TX 79905-2705 EL PASO 11/01/2016 46%

138951211 1316936990 EL PASO COUNTY HOSPITAL DISTRICT-UNIVERSITY MEDICAL CENTER OF EL PASO 4815 ALAMEDA EL PASO, TX 79905-2705 EL PASO 10/01/2016 36%

094109802 1770536120 EL PASO HEALTHCARE SYSTEM LTD-LAS PALMAS MEDICAL CENTER 1801 N OREGON EL PASO, TX 79902-3524 EL PASO 08/01/2016 11%

190248801 1194890103 EL PASO LTAC HOSPITAL 1221 N COTTON ST 3RD FLOOR EL PASO, TX 79902-3015 EL PASO 02/04/2007 50%

112751605 1720094550 EL PASO PSYCHIATRIC CENTER-TDMHMR-EL PASO PSYCHIATRIC CENTER 4615 ALAMEDA AVE EL PASO, TX 79905-2702 EL PASO 01/01/2006 41%

148322401 1366427130 EL PASO SPECIALTY HOSPITAL-SURGICAL INSTITUTE OF EL PASO 1755 CURIE STE A EL PASO, TX 79902-2920 EL PASO 01/01/2016 38%

309798201 1669752234 EMERUS BHS SA THOUSAND OAKS LLC-BAPTIST EMERGENCY HOSPITAL HAUSMAN 16088 SAN PEDRO AVE SAN ANTONIO, TX 78232-2249 BEXAR 01/01/2016 39%

325449201 1144566316 ESWCT CEDAR PARK, LLC-BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CTR AT CEDA900 E WHITESTONE BLVD CEDAR PARK, TX 78613-9093 WILLIAMSON 09/01/2013 50%

133367602 1841294246 FALLS COMMUNITY HOSPITAL AND CLINIC 322 COLEMAN ST MARLIN, TX 76661-2358 FALLS 08/01/2016 45%

330811601 1760417646 FANNIN COUNTY HOSPITAL AUTHORITY-TMC BONHAM HOSPITAL 504 LIPSCOMB ST BONHAM, TX 75418-4028 FANNIN 06/01/2016 49%

354160901 1336533595 FIRST TEXAS HOSPITAL CARROLLTON LLC- 1401 E TRINITY MILLS RD CARROLLTON, TX 75006-1442 DALLAS 11/03/2015 50%

112692202 1598746703 FISHER COUNTY HOSPITAL 774 STATE HWY 70 NORTH ROTAN, TX 79546-6918 FISHER 02/01/2016 100%

217744601 1902047376 FLOWER MOUND HOSPITAL PARTNERS LLC-TEXAS HEALTH PRESBYTERIAN HOSPITAL FLOWER MOUND 4400 LONG PRAIRIE RD FLOWER MOUND, TX 75028-1892 DENTON 04/01/2016 46%

110803703 1770579591 FORT DUNCAN REGIONAL MEDICAL CENTER LP-FORT DUNCAN REGIONAL MEDICAL CENTER 3333 N FOSTER MALDONADO BLVD EAGLE PASS, TX 78852-5893 MAVERICK 01/01/2016 28%

112688002 1952308132 FRIO HOSPITAL 200 S I H 35 PEARSALL, TX 78061-6601 FRIO 06/01/2016 69%

157144001 1922002674 FRISCO MEDICAL CENTER-BAYLOR SCOTT & WHITE MEDICAL CENTER - FRISCO 5601 WARREN PKWY FRISCO, TX 75034 DENTON 01/01/2016 42%

167364201 1871599183 FT WORTH SURGICARE PARTNERS, LTD-BAYLOR SURGICAL HOSPITAL AT FT WORTH 1800 PARK PLACE AVE FORT WORTH, TX 76110-1302 TARRANT 01/01/2016 44%

121777003 1922009331 GAINESVILLE HOSPITAL DISTRICT-NORTH TEXAS MEDICAL CENTER 1900 HOSPITAL BLVD GAINESVILLE, TX 76240-2002 COOKE 10/01/2016 41%

359590201 1649646415 GARLAND BEHAVIORAL HOSPITAL 2300 MARIE CURIE DR FL 5 GARLAND, TX 75042 DALLAS 03/09/2016 50%

309910301 1013910868 GCMC OF WHARTON COUNTY TEXAS LLC-GULF COAST MEDICAL CENTER 10141 US 59 HWY WHARTON, TX 77488-7224 WHARTON 08/01/2016 37%

112728403 1083619712 GENERAL HOSPITAL-IRAAN GENERAL HOSPITAL 600 HWY 349 NORTH IRAAN, TX 79744-0665 PECOS 01/01/2016 100%

345305201 1275956807 GEORGETOWN BEHAVIORAL HEALTH INSTITUTE, LLC- 3101 S AUSTIN AVE GEORGETOWN, TX 78626-7541 WILLIAMSON 10/28/2014 50%

112746602 1922078815 GLEN OAKS HOSPITAL 301 DIVISION ST GREENVILLE, TX 75401-4101 HUNT 06/01/2006 43%

312476002 1396902540 GLOBALREHAB FORT WORTH, LP- 6601 HARRIS PKWY FORT WORTH, TX 76132-6108 TARRANT 11/19/2008 50%

310164401 1306011929 GLOBALREHAB LP- 1340 EMPIRE CENTRAL DR DALLAS, TX 75247-4022 DALLAS 11/19/2008 50%

121785303 1932108214 GONZALES HEALTHCARE SYSTEMS-MEMORIAL HOSPITAL 1110 N SARAH DEWITT DR GONZALES, TX 78629-3311 GONZALES 07/01/2016 97%

137075116 1962455832 GOODALL WITCHER HOSPITAL FOUNDATION- 101 POSEY AVE CLIFTON, TX 76634 BOSQUE 07/01/2016 78%

137075116 1962455832 GOODALL WITCHER HOSPITAL FOUNDATION- 101 POSEY AVE CLIFTON, TX 76634 BOSQUE 11/01/2016 79%

137075109 1962455832 GOODALL WITCHER HOSPITAL FOUNDATION-GOODALL WITCHER HEALTHCARE 101 POSEY AVE CLIFTON, TX 76634-1832 BOSQUE 07/01/2016 78%

131035105 1780649509 GOOD SHEPHERD MEDICAL CENTER LINDEN INC 404 N KAUFMAN ST LINDEN, TX 75563-5234 CASS 06/01/2015 83%

094095902 1689663007 GOOD SHEPHERD MEDICAL CTR-GOOD SHEPHERD MEDICAL CENTER 700 E MARSHALL AVE LONGVIEW, TX 75601-5580 GREGG 10/01/2016 21%

197063401 1841497153 GPCH LLC-GOLDEN PLAINS COMMUNITY HOSPITAL 100 MEDICAL DR BORGER, TX 79007-7579 HUTCHINSON 01/01/2016 51%

346945401 1881691061 GRAHAM HOSPITAL DISTRICT- 1301 MONTGOMERY RD GRAHAM, TX 76450 YOUNG 10/01/2016 100%

021224301 1831140698 GREEN OAKS HOSPITAL SUBSIDIA 7808 CLODUS FIELDS DR DALLAS, TX 75251-2206 DALLAS 06/01/2006 27%

147918003 1154317774 GRIMES ST JOSEPH HEALTH CENTER 210 S. JUDSON NAVASOTA, TX 77868 GRIMES 01/01/2016 65%

Created by HHSC Rate Analysis Division 4 11/16/2016

Page 5: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

138411709 1720088123 GUADALUPE COUNTY HOSPITAL BOARD-GUADALUPE REGIONAL MEDICAL CENTER 1215 EAST COURT SEGUIN, TX 78155-5129 GUADALUPE 09/01/2016 51%

121792903 1326037607 HAMILTON GENERAL HOSPITAL 400 N BROWN HAMILTON, TX 76531-1518 HAMILTON 10/01/2015 49%

110856504 1134137466 HAMILTON HOSPITAL 901 WEST HAMILTON ST OLNEY, TX 76374-1745 YOUNG 05/01/2016 61%

094131202 1396739710 HAMLIN MEMORIAL HOSPITAL 632 NW SECOND HAMLIN, TX 79520-3808 JONES 09/01/2015 100%

094117105 1992707780 HANSFORD COUNTY HOSPITAL DISTRICT-HANSFORD COUNTY HOSPITAL 707 SOUTH ROLAND ST SPEARMAN, TX 79081-3441 HANSFORD 10/01/2015 100%

215330601 1649262528 HARBOR HOSPITAL OF SOUTHEAST TEXAS- 860 S 8TH ST BEAUMONT, TX 77701-4626 JEFFERSON 09/01/2009 50%

121692107 1861510521 HARDEMAN COUNTY MEMORIAL HOSPITAL 402 MERCER ST QUANAH, TX 79252 HARDEMAN 10/01/2012 100%

154504801 1881688976 HARLINGEN MEDICAL CENTER LP- 5501 S EXPRESSWAY 77 HARLINGEN, TX 78550-3213 CAMERON 06/01/2016 25%

133355104 1205900370 HARRIS COUNTY HOSPITAL DISTRICT 1504 TAUB LOOP HOUSTON, TX 77030-1608 HARRIS 03/01/2016 56%

112667403 1124092036 HARRISON COUNTY HOSPITAL ASSOCIATION-GOOD SHEPHERD MEDICAL CENTER MARSHALL 811 S WASHINGTON AVE MARSHALL, TX 75670-5336 HARRISON 10/01/2016 35%

112702904 1184607897 HASKELL MEMORIAL HOSPITAL 1 AVENUE N HASKELL, TX 79521 HASKELL 05/01/2016 100%

355497401 1780025148 HAVEN BEHAVIORAL SERVICES OF FRISCO LLC-HAVEN BEHAVIORAL HOSPITAL OF FRISCO 5680 FRISCO SQUARE BLVD STE 3000 FRISCO, TX 75034-3300 DENTON 01/09/2015 50%

210433301 1710160296 HAVEN RED RIVER HOSPITAL LLC-RED RIVER HOSPITAL 1505 EIGHT STREET WICHITA FALLS, TX 76301-3106 WICHITA 01/29/2010 38%

210661901 1427048743 HAVEN RED RIVER HOSPITAL LLC-RED RIVER HOSPITAL 1505 EIGHTH STREET WICHITA FALLS, TX 76301-3106 WICHITA 01/29/2010 38%

021185601 1013968726 HEALTHBRIDGE CHILDRENS HOSPITAL- HOUSTON LTD-HEALTHBRIDGE CHILDRENS HOSPITAL 2929 WOODLAND PARK DR HOUSTON, TX 77082-2687 HARRIS 07/01/2016 40%

199329701 1699749341 HEALTH SOUTH CITY VIEW REHABILITATION HOSPITAL 6701 OAKMONT BLVD FORT WORTH, TX 76132-2957 TARRANT 09/01/2006 50%

094347402 1144294893 HEALTHSOUTH PLANO REHABILITATION HOSPITAL LLC-HEALTHSOUTH PLANO REHABILITATION HOSPITAL 2800 W 15TH ST PLANO, TX 75075-7526 COLLIN 09/01/2006 80%

309446801 1548546088 HEALTHSOUTH REHAB HOSPITAL OF SOUTH AUSTIN LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF SOUTH AUST330 W BEN WHITE BLVD AUSTIN, TX 78704-8095 TRAVIS 06/29/2012 50%

288662403 1427374222 HEALTHSOUTH REHAB HOSPITAL OF THE MID-CITIES LLC-RELIANT REHABILITATION HOSPITAL MID CITIES 2304 HIGHWAY 121 BEDFORD, TX 76021-5985 TARRANT 11/05/2010 80%

094351601 1821061532 HEALTHSOUTH REHABILITATION-HEALTHSOUTH REHABILITATION HOSPITAL OF MIDLAND/ODE1800 HERITAGE BLVD MIDLAND, TX 79707-9750 MIDLAND 09/01/2006 52%

209804801 1477731156 HEALTHSOUTH REHABILITATION HOSPITAL NORTH HOUSTON-HEALTHSOUTH REHABILITATION HOSPITAL VISION PARK 117 VISION PARK BLVD SHENANDOAH, TX 77384-3001 MONTGOMERY 01/23/2009 80%

313188001 1659539567 HEALTHSOUTH REHABILITATION HOSPITAL OF ABILENE LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF ABILENE 6401 DIRECTORS PKWY ABILENE, TX 79606-5869 TAYLOR 10/30/2009 50%

094345801 1568435279 HEALTHSOUTH REHABILITATION HOSPITAL OF AUSTIN 1215 RED RIVER ST AUSTIN, TX 78701-1921 TRAVIS 06/01/2013 44%

301006801 1275813610 HEALTHSOUTH REHABILITATION HOSPITAL OF CYPRESS LLC- 13031 WORTHAM CENTER DR HOUSTON, TX 77065-5662 HARRIS 09/01/2012 50%

314562501 1982920773 HEALTHSOUTH REHABILITATION HOSPITAL OF DALLAS LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF DALLAS 7930 NORTHAVEN RD DALLAS, TX 75230-3331 DALLAS 10/07/2010 50%

094343302 1851364558 HEALTHSOUTH REHABILITATION HOSPITAL OF FORT WORTH-HEALTHSOUTH REHABILITATION HOPSITAL OF FORT WORTH 1212 W LANCASTER FORT WORTH, TX 76102-4510 TARRANT 01/01/2011 100%

337018101 1366871600 HEALTH SOUTH REHABILITATION HOSPITAL OF HUMBLE- 19002 MCKAY DR HUMBLE, TX 77338-5701 HARRIS 01/01/2014 83%

199238001 1720279342 HEALTHSOUTH REHABILITATION HOSPITAL OF RICHARDSON 3351 WATERVIEW PKWY RICHARDSON, TX 77080-1449 HARRIS 02/01/2016 56%

209190201 1245422567 HEALTHSOUTH REHABILITATION HOSPITAL OF ROUND ROCK 1400 HESTERS CROSSING RD ROUND ROCK, TX 78681-8025 WILLIAMSON 07/09/2008 50%

094352403 1194798801 HEALTHSOUTH REHABILITATION HOSPITAL THE WOODLANDS-HEALTHSOUTH REHAB HOSPITAL THE WOODLANDS 18550 IH 45S CONROE, TX 77384-4119 MONTGOMERY 09/01/2004 50%

021175701 1649243353 HEALTHSOUTH REHABILITATION OF TEXARKANA INC 515 W 12TH ST TEXARKANA, TX 75501-4416 BOWIE 09/01/2006 29%

021168201 1548233265 HEALTHSOUTH REHAB INSTITUTUE OF SAN ANTONIO (RIOSA-HEALTHSOUTH REHAB INSTITUTUE OF SAN ANTONIO 9119 CINNAMON HL SAN ANTONIO, TX 78240-5401 BEXAR 09/01/2006 40%

219907701 1518287721 HEALTHSOUTH SUGAR LAND REHABILITATION HOSPITAL 1325 HIGHWAY 6 SUGAR LAND, TX 77478-4906 FORT BEND 10/05/2010 50%

322916301 1558349399 HEART OF TEXAS HEALTHCARE SYSTEM- 2008 NINE RD BRADY, TX 76825-7210 MCCULLOCH 04/01/2016 81%

109588703 1558354241 HEMPHILL COUNTY HOSPITAL 1020 S FOURTH ST CANADIAN, TX 79014-3315 HEMPHILL 10/01/2016 100%

021012201 1992709661 HENDRICK CENTER FOR EXTENDED CARE-CONTINUECARE HOSPITAL HENDRICK MEDICAL CENTER 1900 PINE ABILENE, TX 79601-2432 TAYLOR 07/01/2008 28%

138644310 1528064649 HENDRICK MEDICAL CENTER 1900 PINE ABILENE, TX 79601-2432 TAYLOR 09/01/2016 24%

361699701 1235510090 HERITAGE PARK SURGICAL HOSPITAL, LLC-BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN 3601 N CALAIS ST SHERMAN, TX 75090-1785 GRAYSON 12/22/2010 50%

312239201 1841562709 HH KILLEEN HEALTH SYSTEM LLC- 850 W CENTRAL TEXAS EXPY HARKER HEIGHTS, TX 76548-1890 BELL 04/01/2016 39%

184076101 1205999232 HICKORY TRAIL HOSPITAL LP 2000 OLD HICKORY TRL DESOTO, TX 75115-2242 DALLAS 07/01/2006 73%

021182301 1710976402 HIGHLANDS REGIONAL REHABILITATION HOSPITAL-HIGHLANDS REGIONAL REHABILIT 1395 GEORGE DIETER DRIVE EL PASO, TX 79936-7410 EL PASO 06/01/2016 82%

136430906 1497726343 HILL COUNTRY MEMORIAL-HILL COUNTRY MEMORIAL HOSP 1020 S STATE HIGHWAY 16 FREDERICKSBURG, TX 78624-4471 GILLESPIE 02/01/2016 59%

138962907 1891882833 HILLCREST BAPTIST MEDICAL CENTER-BAYLOR SCOTT & WHITE MEDICAL CENTER-HILLCREST 100 HILLCREST MEDICAL BLVD WACO, TX 76712-8897 MCLENNAN 09/01/2016 34%

021215102 1689692402 HMIH CEDAR CREST LLC-CEDAR CREST HOSPITAL 3500 S IH 35 BELTON, TX 76513-9426 BELL 11/01/2005 61%

342612401 1780022319 HOPEBRIDGE, LLC-HOPEBRIDGE HOSPITAL 5556 GASMER DR HOUSTON, TX 77035-4563 HARRIS 03/01/2015 71%

131037707 1598757775 HOPKINS COUNTY HOSPITAL DISTRICT- 115 AIRPORT RD SULPHUR SPRINGS, TX 75482-2105 HOPKINS 09/01/2012 62%

131037704 1184618548 HOPKINS COUNTY HOSPITAL DISTRICT-HOPKINS COUNTY MEMORIAL HOSPITAL 115 AIRPORT ROAD SULPHUR SPRINGS, TX 75482-2105 HOPKINS 09/01/2016 74%

192996002 1962614834 HORIZON HEALTH AUSTIN INC-AUSTIN LAKES HOSPITAL 1025 E 32ND STREET AUSTIN, TX 78705-2714 TRAVIS 12/12/2007 80%

348990801 1689098790 HOUSTON BEHAVIORAL HEALTHCARE HOSPITAL, LLC- 2801 GESSNER RD HOUSTON, TX 77080-2503 HARRIS 03/25/2015 50%

360991901 1306223458 HOUSTON COUNTY HOSPITAL DISTRICT- 1100 E LOOP 304 CROCKETT, TX 75835 HOUSTON 09/01/2016 38%

342897101 1306268321 HOUSTON METHODIST ST CATHERINE HOSPITAL- 701 S FRY RD KATY, TX 77450 HARRIS 07/01/2014 56%

342897103 1306268321 HOUSTON METHODIST ST CATHERINE HOSPITAL-HOUSTON METHODIST ST CATHERINE HOSPITAL. 701 S FRY RD KATY, TX 77450-2237 HARRIS 09/01/2013 50%

336478801 1952723967 HOUSTON METHODIST ST JOHN HOSPITAL- 18300 SAINT JOHN DR HOUSTON, TX 77058-6302 HARRIS 08/01/2016 25%

193867201 1740450121 HOUSTON NORTHWEST OPERATING COMPANY LLC-HOUSTON NORTHWEST MEDICAL CENTER 710 CYPRESS CREEK PKWY HOUSTON, TX 77090-3402 HARRIS 06/01/2016 20%

Created by HHSC Rate Analysis Division 5 11/16/2016

Page 6: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

131038504 1598750721 HUNT MEMORIAL HOSPITAL DISTRICT-HUNT REGIONAL MEDICAL CENTER 4215 JOE RAMSEY BLVD GREENVILLE, TX 75401-7852 HUNT 10/01/2016 41%

212167501 1548406788 ICON HOSPITAL, LLP- 19211 MCKAY BLVD HUMBLE, TX 77338-5502 HARRIS 02/01/2009 50%

094232802 1215937966 IHS HOSPITAL AT EL PASO 2311 N OREGON EL PASO, TX 79902-3216 EL PASO 12/31/1997 80%

112730002 1851785521 IHS HOSPITAL OF AMARILLO 5601 PLUM CREEK DR AMARILLO, TX 79124-1801 POTTER 11/01/2010 53%

094381301 1033107826 INTRACARE HOSPITAL NORTH-INTRACARE NORTH HOSPITAL 1120 CYPRESS STATION HOUSTON, TX 77090-3002 HARRIS 09/01/2006 40%

112749002 1538157326 INTRACARE MEDICAL CENTER-INTRACARE MEDICAL CENTER HOSPITAL 7601 FANNIN HOUSTON, TX 77054-1905 HARRIS 09/01/2006 48%

163936101 1669569984 IRVING COPPELL SURGICAL HOSPITAL LLP-IRVING-COPPELL SURGICAL HOSPITAL LLP 400 W INTERSTATE 635 STE 101 IRVING, TX 75063-1158 DALLAS 03/01/2012 50%

119874904 1790777696 JACK COUNTY HOSPITAL DISTRICT-FAITH COMMUNITY HOSPITAL 215 CHISHOLM TRL JACKSBORO, TX 76458-1403 JACK 06/01/2016 100%

121808305 1124061882 JACKSON COUNTY HOSPITAL DISTRICT-JACKSON HEALTHCARE CENTER 1013 S WELLS ST EDNA, TX 77957-4045 JACKSON 10/01/2016 100%

136412710 1699772541 KARNES COUNTY HOSPITAL DISTRICT-OTTO KAISER MEMORIAL HOSPITAL 3349 S HWY 181 KENEDY, TX 78119-5240 KARNES 08/01/2016 82%

168648701 1669480323 KELL WEST REGIONAL HOSPITAL LLC-KELL WEST REGIONAL HOSPITAL 5420 KELL WEST BOULEVARD WICHITA FALLS, TX 76310-2542 WICHITA 01/01/2016 62%

021001501 1699844654 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL- DALLAS 9525 GREENVILLE AVE DALLAS, TX 75243-4116 DALLAS 12/01/2006 25%

164466801 1598834566 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL-FORT WORTH 815 EIGHTH AVENUE FORT WORTH, TX 76104-2609 TARRANT 08/01/2008 100%

164466801 1598834566 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL-FORT WORTH 815 EIGHTH AVENUE FORT WORTH, TX 76104-2609 TARRANT 11/01/2016 25%

021004901 1922177997 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL - MANSFIELD 1802 HIGHWAY 157 N MANSFIELD, TX 76063-3923 TARRANT 12/01/2006 26%

021002301 1558430520 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITALS SAN ANTONIO 3636 MEDICAL DRIVE SAN ANTONIO, TX 78229-2183 BEXAR 05/01/2014 42%

149633301 1821167818 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL-WHITE ROCK 9440 POPPY DR -5TH FLOOR SOUTH DALLAS, TX 75218-3652 DALLAS 09/01/2004 50%

021008001 1942379912 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPTIAL HOUSTON MEDICAL CENTER 6441 MAIN STREET HOUSTON, TX 77030-1502 HARRIS 09/01/2010 50%

112724302 1811942238 KINGWOOD PLAZA HOSPITAL-KINGWOOD MEDICAL CENTER 22999 HIGHWAY 59 N KINGWOOD, TX 77339-4438 HARRIS 10/01/2016 15%

135035706 1861488579 KNAPP MEDICAL CENTER 1401 E 8TH ST WESLACO, TX 78596-6640 HIDALGO 08/01/2016 32%

121053602 1487639175 KNOX COUNTY HOSPITAL 701 SE 5TH ST KNOX CITY, TX 79529-2107 KNOX 10/01/2016 100%

094178302 1114998911 LAKE GRANBURY MEDICAL CENTER 1310 PALUXY RD GRANBURY, TX 76048-5655 HOOD 01/01/2016 20%

020966001 1205018439 LAKE POINTE MEDICAL CENTER 6800 SCENIC DR ROWLETT, TX 75088-4552 DALLAS 06/01/2016 21%

181544101 1851323240 LAKESIDE HOSPITAL AT BASTROP LTD 3201 HIGHWAY 71 EAST BASTROP, TX 78602-9100 BASTROP 06/01/2010 40%

310443201 1831471291 LAKEWAY REGIONAL MEDICAL CENTER LLC- 100 MEDICAL PKWY LAKEWAY, TX 78738-5621 TRAVIS 04/01/2016 100%

127313803 1700854288 LAMB HEALTHCARE CENTER 1500 S SUNSET LITTLEFIELD, TX 79339-4899 LAMB 09/01/2016 100%

331242301 1851632616 LANCASTER REGIONAL HOSPITAL LP- 2600 W PLEASANT RUN RD LANCASTER, TX 75146-1114 DALLAS 06/01/2016 100%

162033801 1548232044 LAREDO MEDICAL CENTER 1700 E SAUNDERS STREET LAREDO, TX 78041-5401 WEBB 10/01/2016 13%

094186602 1396731105 LAREDO REGIONAL MEDICAL CENTER LP-DOCTORS HOSPITAL OF LAREDO 10700 MCPHERSON RD LAREDO, TX 78045-6268 WEBB 01/01/2016 21%

350658601 1710389929 LAREDO REHABILITATION HOSPITAL LLC- 2005A E BUSTAMANTE ST LAREDO, TX 78041-5470 WEBB 02/26/2015 50%

185051301 1316992878 LAREDO SPECIALTY HOSPITAL 2005 BUSTAMANIE LAREDO, TX 78041-5470 WEBB 07/07/2006 50%

020979301 1902857766 LAS COLINAS MEDICAL CENTER 6800 N MACARTHUR BLVD IRVING, TX 75039-2422 DALLAS 10/01/2016 26%

135233809 1992767511 LAVACA MEDICAL CENTER HBP-LAVACA MEDICAL CENTER 1400 N TEXANA ST HALLETTSVILLE, TX 77964-2021 LAVACA 01/01/2016 61%

284333604 1154324952 LIBERTY COUNTY HOSPITAL DISTRICT NO 1-LIBERTY DAYTON REGIONAL MEDICAL CENTER 1353 N TRAVIS ST LIBERTY, TX 77575-3549 LIBERTY 10/01/2016 97%

121781205 1831140979 LILLIAN M HUDSPETH MEMORIAL ER PHYS-LILLIAN M HUDSPETH MEMORIAL HOSPITAL 308 HUDSPETH ST SONORA, TX 76950-8003 SUTTON 12/01/2014 82%

140714001 1861487779 LIMESTONE MEDICAL CENTER 701 MCCLINTIC GROESBECK, TX 76642-2128 LIMESTONE 08/01/2016 80%

342027501 1619303641 LITTLE RIVER HEALTHCARE CAMERON HOSPITAL- 806 N CROCKETT AVE CAMERON, TX 76520-2553 MILAM 07/19/2014 50%

110839103 1528026267 LONGVIEW MEDICAL CENTER LP-LONGVIEW REGIONAL MEDICAL CENTER 2901 N 4TH ST LONGVIEW, TX 75605-5128 GREGG 10/01/2016 20%

213659001 1750523593 LTHM HOUSTON OPERATIONS LLC-ST ANTHONYS HOSPITAL 2807 LITTLE YORK RD HOUSTON, TX 77093-3405 HARRIS 01/01/2015 9%

163219201 1922001775 LUBBOCK HEART HOSPITAL LP-LUBBOCK HEART HOSPITAL 4810 N LOOP 289 LUBBOCK, TX 79416-3025 LUBBOCK 02/01/2016 42%

136492909 1265648513 LUBBOCK REGIONAL MHMR CENTER-SUD-LUBBOCK REGIONAL MHMR CENTER 1950 ASPEN AVE LUBBOCK, TX 79404-1211 LUBBOCK 09/01/2012 50%

071672202 1467442749 LUCILE PACKARD CHILDRENS HOSPITAL- 725 WELCH RD PALO ALTO, CA 94304-1601 OUTOFSTATE 03/10/2015 50%

094180903 1821066820 LYNN COUNTY HOSPITAL-LYNN COUNTY HOSPITAL DISTRICT 2600 LOCKWOOD TAHOKA, TX 79373 LYNN 10/01/2016 85%

020990001 1780731737 MADISON ST JOSEPH HEALTH CENTER 1101 WEST CROSS ST MADISONVILLE, TX 77864 MADISON 01/01/2015 40%

136145310 1679560866 MARTIN COUNTY HOSPITAL DISTRICT 600 EAST I 20 STANTON, TX 79782-0640 MARTIN 05/01/2015 100%

130959304 1679678767 MATAGORDA COUNTY HOSPITAL DISTRICT-MATAGORDA REGIONAL MEDICAL CENTER 104 7TH ST BAY CITY, TX 77414-4853 MATAGORDA 10/01/2016 67%

283280001 1871898478 MAYHILL BEHAVIORAL HEALTH LLC- 2809 S MAYHILL RD DENTON, TX 76208-5910 DENTON 12/01/2015 27%

094172602 1023013935 MCCAMEY HOSPITAL 2500 S HWY 305 MCCAMEY, TX 79752-1200 UPTON 09/01/2014 100%

112672402 1174582050 M.D. ANDERSON HOSP.-MD ANDERSON HOSPITAL 1515 HOLCOMBE BLVD HOUSTON, TX 77030-4009 HARRIS 09/01/2016 44%

094192402 1255384533 MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP-MEDICAL CENTER OF LEWISVILLE 500 WEST MAIN LEWISVILLE, TX 75057-3629 DENTON 06/01/2016 19%

212140201 1427048453 MEDINA COUNTY HOSPITAL DISTRICT- 3100 AVENUE E HONDO, TX 78861-3534 MEDINA 09/01/2016 86%

020834001 1730132234 MEMORIAL HERMANN HEALTH SYSTEM-MHHS THE WOODLANDS HOSPITAL 1635 NORTH LOOP W HOUSTON, TX 77008-1532 HARRIS 07/01/2016 33%

337433201 1710985098 MEMORIAL HERMANN HEALTH SYSTEM-TIRR MEMORIAL HERMANN 1333 MOURSUND ST HOUSTON, TX 77030-3405 HARRIS 01/01/2016 45%

137805107 1982666111 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS HERMANN HOSPITAL 6411 FANNIN ST HOUSTON, TX 77030-1501 HARRIS 09/01/2016 29%

Created by HHSC Rate Analysis Division 6 11/16/2016

Page 7: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

146509801 1932152337 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS KATY HOSPITAL 23900 KATY FWY KATY, TX 77494-1323 FORT BEND 06/01/2016 33%

020934801 1740233782 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS MEMORIAL CITY HOSPITAL 921 GESSNER RD HOUSTON, TX 77024-2315 HARRIS 07/01/2016 38%

192751901 1295843787 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS NORTHEAST HOSPITAL 18951 MEMORIAL NORTH HUMBLE, TX 77338-4217 HARRIS 01/01/2016 29%

146021401 1295788735 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS SUGAR LAND HOSPITAL 17500 WEST GRAND PARKWAY SOUTH SUGAR LAND, TX 77479-2562 FORT BEND 10/01/2016 35%

220238402 1043457583 MEMORIAL HERMANN REHABILITATION HOSPITAL KATY- 21720 KINGSLAND BLVD STE 102 KATY, TX 77450-2551 HARRIS 09/01/2011 50%

202351701 1366532228 MEMORIAL HERMANN SPECIALTY HOSPITAL KINGWOOD LLC 300 KINGWOOD MEDICAL DR KINGWOOD, TX 77339-6400 HARRIS 12/01/2014 41%

201645301 1033114608 MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL LLP-SUGAR LAND SURGICAL HOSPITAL 16906 SOUTHWEST FWY SUGAR LAND, TX 77479-2350 FORT BEND 02/01/2012 36%

094121303 1821025990 MEMORIAL HOSPITAL 209 NW 8TH ST SEMINOLE, TX 79360-3447 GAINES 10/01/2016 100%

131030203 1801831748 MEMORIAL HOSPITAL 1204 MOUND NACOGDOCHES, TX 75961-4027 NACOGDOCHES 07/01/2016 62%

131030209 1780612754 MEMORIAL HOSPITAL- 1204 N MOUND ST NACOGDOCHES, TX 75961-4027 NACOGDOCHES 04/01/2012 46%

112697102 1689650616 MEMORIAL HOSP OF POLK COUNTY-MEMORIAL MEDICAL CENTER LIVINGSTON 1717 HIGHWAY 59 BYPASS LIVINGSTON, TX 77351-5703 POLK 08/01/2016 32%

137909111 1689630865 MEMORIAL MEDICAL CENTER 815 N VIRGINIA PORT LAVACA, TX 77979-0025 CALHOUN 02/01/2016 49%

139172412 1396746129 MEMORIAL MEDICAL CENTER OF EAST TEXAS-MEMORIAL MED CTR OF EAST TX 1201 FRANK STREET LUFKIN, TX 75904-1447 ANGELINA 07/01/2016 24%

130734007 1578547345 MEMORIAL MEDICAL CENTER SAN AUGUSTINE 511 E HOSPITAL ST SAN AUGUSTINE, TX 75972-0658 SAN AUGUSTINE 07/01/2016 59%

121821603 1497731426 MEMORIAL SPECIALTY HOSPITAL 1201 FRANK AVE STE D5 LUFKIN, TX 75902-1447 ANGELINA 11/01/2014 45%

353570001 1285028951 MESA HILLS SPECIALTY HOSPITAL OPERATOR, LLC-MESA HILLS SPECIALTY HOSPITAL 2311 N OREGON ST EL PASO, TX 79902 EL PASO 04/01/2015 32%

339487601 1366880627 MESA SPRINGS, LLC- 5560 MESA SPRINGS DR FORT WORTH, TX 76123-2120 TARRANT 02/28/2014 50%

218319601 1831146331 MESQUITE SPECIALTY HOSPITAL LP 1024 N GALLOWAY AVE MESQUITE, TX 75149-2434 DALLAS 09/01/2009 50%

121820803 1871560003 METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP-METHODIST AMBULATORY SURGERY 9150 HUEBNER RD STE 100 SAN ANTONIO, TX 78240-1558 BEXAR 12/01/2013 31%

204254101 1659525236 METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP-METHODIST STONE OAK HOSPITAL 1139 E SONTERRA BLVD SAN ANTONIO, TX 78258-3999 BEXAR 05/01/2016 20%

281028501 1083937593 METHODIST HEALTH CENTERS-METHODIST WEST HOUSTON HOSPITAL 18500 KATY FWY HOUSTON, TX 77094-1110 HARRIS 01/01/2016 41%

094154402 1124074273 METHODIST HOSPITAL 7700 FLOYD CURL DR SAN ANTONIO, TX 78229-3902 BEXAR 08/01/2016 19%

133258705 1225146400 METHODIST HOSPITAL LEVELLAND INC-COVENANT HOSPITAL LEVELLAND 1900 COLLEGE AVE LEVELLAND, TX 79336-6508 HOCKLEY 07/01/2016 64%

126679303 1275592131 METHODIST HOSPITAL OF DALLAS-METHODIST CHARLTON MEDICAL CENTER 3500 W WHEATLAND RD DALLAS, TX 75237-3460 DALLAS 07/01/2016 28%

186221101 1689629941 METHODIST HOSPITAL OF DALLAS-METHODIST MANSFIELD MEDICAL CENTER 2700 E BROAD ST MANSFIELD, TX 76063-5899 TARRANT 07/01/2016 26%

127263503 1073580726 METHODIST HOSPITAL PLAINVIEW-COVENANT HOSPITAL PLAINVIEW 2601 DIMMITT RD PLAINVIEW, TX 79072-1833 HALE 08/01/2015 33%

135032405 1528027786 METHODIST HOSPITALS OF DALLAS-METHODIST DALLAS MEDICAL CENTER 1441 N BECKLEY AVE DALLAS, TX 75203-1201 DALLAS 07/01/2016 32%

209345201 1033165501 METHODIST HOSPITALS OF DALLAS-METHODIST RICHARDSON MEDICAL CENTER 2831 E PRESIDENT GEORGE BUSH HWY RICHARDSON, TX 75082-3561 DALLAS 07/01/2016 34%

328934001 1952538431 METHODIST MCKINNEY HOSPITAL LLC- 8000 ELDORADO PKWY MCKINNEY, TX 75070-5940 COLLIN 09/01/2013 50%

127319504 1437171568 METHODISTS CHILDRENS HOSPITAL-COVENANT CHILDRENS HOSPITAL 4015 22ND PL LUBBOCK, TX 79410-1119 LUBBOCK 09/01/2016 25%

094219503 1497871628 METHODIST SUGAR LAND HOSPITAL-HOUSTON METHODIST SUGAR LAND HOSPITAL 16655 SOUTHWEST FWY SUGAR LAND, TX 77479-2329 FORT BEND 01/01/2016 26%

140713201 1871619254 METHODIST WILLOWBROOK-HOUSTON METHODIST WILLOWBROOK HOSPITAL 18220 TOMBALL PKWY HOUSTON, TX 77070-4347 HARRIS 08/01/2016 23%

094119702 1629089966 METROPLEX ADVENTIST HOSPITAL INC-METROPLEX HOSPITAL 2201 SOUTH CLEAR CREEK RD KILLEEN, TX 76549-4110 BELL 10/01/2016 34%

149073203 1750392916 METROPLEX ADVENTIST HOSPITAL INC-ROLLINS BROOK COMMUNITY HOSPITAL 608 N KEY AVE LAMPASAS, TX 76550-1106 LAMPASAS 10/01/2016 45%

357475801 1346630316 MID JEFFERSON EXTENDED CARE HOSPITAL- 2600 HIGHWAY 365 NEDERLAND, TX 77627 JEFFERSON 11/01/2011 67%

136143806 1255325817 MIDLAND MEMORIAL HOSPITAL 400 ROSALIND REDFERN GROVER PARKWAY MIDLAND, TX 79701-9980 MIDLAND 10/01/2016 42%

021189801 1023015120 MILLWOOD HOSPITAL 1011 NORTH COOPER STREET ARLINGTON, TX 76011-5517 TARRANT 09/01/2006 21%

112679902 1205833985 MISSION HOSPITAL INC-MISSION REGIONAL MEDICAL CENTER 900 SOUTH BRYAN RD MISSION, TX 78572-6613 HIDALGO 10/01/2016 31%

136325111 1184631673 MITCHELL COUNTY HOSPITAL DISTRICT-MITCHELL COUNTY HOSPITAL 997 W INTERSTATE 20 COLORADO CITY, TX 79512 MITCHELL 11/01/2015 97%

094129604 1700991700 MOORE COUNTY HOSPITAL- 224 E 2ND ST DUMAS, TX 79029-3808 MOORE 07/01/2016 55%

094129602 1700991700 MOORE COUNTY HOSPITAL-MEMORIAL HOSPITAL 224 E 2ND ST DUMAS, TX 79029-3808 MOORE 07/01/2016 55%

141858401 1952306672 MOTHER FRANCES HOSPITAL JACKSONVILLE 2026 S JACKSON ST JACKSONVILLE, TX 75766-5822 CHEROKEE 07/01/2016 25%

094108002 1679578439 MOTHER FRANCES HOSPITAL REGIONAL HEALTHCARE CENTER-MOTHER FRANCES HOSPITAL 800 E DAWSON ST TYLER, TX 75701-2036 SMITH 07/01/2016 18%

127301306 1659308948 MOTHER FRANCES HOSPITAL WINNSBORO 719 W COKE RD WINNSBORO, TX 75494-3011 WOOD 05/01/2016 75%

094159302 1386647717 MSH PARTNERS LLC-BAYLOR MEDICAL CENTER AT UPTOWN 2727 E LEMMON AVE DALLAS, TX 75204-2833 DALLAS 01/01/2016 47%

120745806 1699770149 MUENSTER HOSPITAL DISTRICT-MUENSTER MEMORIAL HOSPITAL 605 N MAPLE ST MUENSTER, TX 76252-2425 COOKE 07/01/2015 100%

130605205 1700885076 NACOGDOCHES MEDICAL CENTER 4920 NE STALLINGS DR NACOGDOCHES, TX 75965-1254 NACOGDOCHES 01/01/2016 16%

112701102 1144274226 NAVARRO REGIONAL HOSPITAL 3201 W STATE HIGHWAY 22 CORSICANA, TX 75110-2450 NAVARRO 04/01/2016 24%

147227603 1760482939 NEURO INSTITUTE OF AUSTIN LP-TEXAS NEUROREHAB CENTER 1106 W DITTMAR RD AUSTIN, TX 78745-6328 TRAVIS 01/01/2016 42%

291429301 1801191853 NEW BRAUNFELS REG REHAB HOSP INC- 2041 SUNDANCE PKWY NEW BRAUNFELS, TX 78130-2779 COMAL 08/26/2011 50%

331172201 1023451077 NEW LIFECARE HOSPITALS OF NORTH TEXAS LLC- 1950 RECORD CROSSING RD DALLAS, TX 75235-6223 DALLAS 05/31/2013 39%

330847001 1679916530 NEW LIFECARE HOSPITALS OF SOUTH TEXAS LLC- 2001 S M ST MCALLEN, TX 78503-1551 HIDALGO 05/31/2013 50%

112718503 1477583334 NEW MEDICAL HORIZONS II LTD-CYPRESS FAIRBANKS MED CTR 10655 STEEPLETOP DR HOUSTON, TX 77065-4222 HARRIS 01/01/2016 22%

329623801 1942643804 NEW SAN ANTONIO SPECIALTY HOSPITAL LLC-LIFE CARE HOSPITALS OF SAN ANTONIO 8902 FLOYD CURL DR SAN ANTONIO, TX 78240-1681 BEXAR 05/31/2013 50%

Created by HHSC Rate Analysis Division 7 11/16/2016

Page 8: Inpatient Ratio of Cost to Charges Effective 10/1/2016 · 121789503 1821009242 adventist health system sunbelt inc-central texasmedical center 1301 wonder world dr san marcos, tx

TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

133252005 1093786204 NHCI OF HILLSBORO INC-HILL REGIONAL HOSPITAL 101 CIRCLE DR HILLSBORO, TX 76645-0000 HILL 06/01/2016 42%

331941001 1427390574 NIX COMMUNITY GENERAL HOSPITAL LLC-NIX GENERAL HOSPITAL 230 W MILLER ST DILLEY, TX 78017-3818 FRIO 08/08/2013 50%

297342201 1801168190 NIX HOSPITALS SYSTEM LLC- 414 NAVARRO ST STE 600 SAN ANTONIO, TX 78205-2541 BEXAR 01/01/2016 21%

127310404 1689655912 NOCONA GENERAL HOSPITAL 100 PARK RD NOCONA, TX 76255-3616 MONTAGUE 07/01/2016 69%

121845505 1245315647 NORTH BAY GENERAL HOSPITAL INC 1711 W WHEELER AVE ARANSAS PASS, TX 78336-4536 SAN PATRICIO 01/01/2016 27%

185964702 1548236524 NORTH CENTRAL SURGICAL CENTER LLP 9301 N CENTRAL EXPY STE 100 DALLAS, TX 75231-0802 DALLAS 09/01/2009 50%

189049301 1285681064 NORTH CYPRESS MEDICAL CENTER OPERATION COMPANY LTD-NORTH CYPRESS MEDICAL CENTER 21214 NORTHWEST FWY CYPRESS, TX 77429-3373 HARRIS 01/01/2016 17%

020989201 1205837770 NORTH RUNNELS COUNTY HOSPITAL- 7821 STATE HIGHWAY 153 WINTERS, TX 79567-7345 RUNNELS 04/01/2015 100%

350857401 1871911016 NORTH TEXAS - MCA, LLC-MEDICAL CENTER OF ALLIANCE 3101 N TARRANT PKWY FORT WORTH, TX 76177-8601 TARRANT 03/15/2015 50%

021196301 1245344472 NORTH TEXAS STATE HOSPITAL VERNON-NORTH TEXAS STATE HOSPITAL 4730 COLLEGE DR VERNON, TX 76384 WILBARGER 05/01/2006 84%

021195501 1477669208 NORTH TEXAS STATE HOSPITAL WICHITA FALLS-NORTH TEXAS STATE HOSPITAL 6515 KEMP BLVD WICHITA FALLS, TX 76308 WICHITA 05/01/2006 77%

137245009 1467442418 NORTHWEST TEXAS HEALTH CARE SYSTEM INC-NORTHWEST TEXAS HOSPITAL 1501 S COULTER ST AMARILLO, TX 79106-1770 POTTER 01/01/2016 20%

094211203 1003842212 NORTHWEST TEXAS SURGICAL CNT 3501 SONCY RD STE 118 AMARILLO, TX 79119-6407 RANDALL 12/01/2014 27%

121787905 1396748471 NORTH WHEELER COUNTY HOSTPIAL DISTRICT-PARKVIEW HOSPITAL 901 SWEETWATER WHEELER, TX 79096-1030 WHEELER 01/01/2011 100%

127303903 1700883196 OAK BEND MEDICAL CENTER-OAKBEND MEDICAL CENTER 1705 JACKSON ST RICHMOND, TX 77469-3246 FORT BEND 01/01/2016 35%

333366801 1750620456 OCEANS BEHAVIORAL HOSPITAL OF ABILENE LLC- 6401 DIRECTORS PKWY ABILENE, TX 79606-5869 TAYLOR 11/07/2013 80%

341027602 1689004939 OCEANS BEHAVORIAL HOSPITAL OF LUFKIN LLC 302 GOBBLERS KNOB RD LUFKIN, TX 75904-5419 ANGELINA 03/19/2014 50%

358963201 1255708715 OCH HOLDINGS-OUR CHILDREN'S HOUSE 3301 SWISS CIR DALLAS, TX 75204 DALLAS 01/01/2016 52%

112704504 1245237593 OCHILTREE GENERAL HOSPITAL 3101 GARRETT DR PERRYTON, TX 79070-5323 OCHILTREE 10/01/2016 100%

112711003 1801852736 ODESSA REGIONAL HOSPITAL LP-ODESSA REGIONAL MEDICAL CENTER 520 EAST 6TH ST ODESSA, TX 79761-4527 ECTOR 10/01/2016 20%

281929401 1669796777 OGLETHORPE OF LONGVIEW LLC- 22 BERMUDA LN LONGVIEW, TX 75605-2902 GREGG 05/11/2011 80%

158914501 1295890093 ORTHOPEDIC AND SPINE SURGICAL HOSPITAL OF S TX LP-SOUTH TEXAS SPINE AND SURGICAL HOSPITAL LP 18600 N HARDY OAK BLVD SAN ANTONIO, TX 78258-4206 BEXAR 05/01/2016 25%

020977701 1134166192 ORTHOPEDIC HOSPITAL LTD-TEXAS ORTHOPEDIC HOSPITAL 7401 MAIN ST HOUSTON, TX 77030-4509 HARRIS 01/01/2016 14%

152686501 1780786699 PALACIOS COMMUNITY MEDICAL CENTER 311 GREEN AVE PALACIOS, TX 77465-3213 MATAGORDA 12/01/2014 100%

121816602 1164510673 PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP-PALESTINE REGIONAL MEDICAL CENTER 2900 S LOOP 256 PALESTINE, TX 75801-6958 ANDERSON 03/01/2016 20%

138950412 1972590602 PALO PINTO GENERAL HOSPITAL 400 SW 25TH AVE MINERAL WELLS, TX 76067-8246 PALO PINTO 10/01/2016 62%

308032701 1386902138 PAMPA REGIONAL MEDICAL CENTER- 1 MEDICAL PLAZA PAMPA, TX 79065-2819 GRAY 06/01/2016 26%

346300201 1467853051 PAM SQUARED AT CORPUS CHRISTI LLC-PAM SPECIALTY HOSPITAL AT CORPUS CHRISTI NORTH 600 ELIZABETH ST FL 3 CORPUS CHRISTI, TX 78404 NUECES 11/03/2014 47%

346138602 1225439821 PAM SQUARED AT TEXARKANA, LLC- 2400 SAINT MICHAEL DR FL 2 TEXARKANA, TX 75503 BOWIE 11/03/2014 34%

357622501 1942601547 PAM SQUARED AT TEXARKANA, LLC-PAM SPECIALTY HOSPITAL OF TEXARKANA SOUTH 1000 PINE ST TEXARKANA, TX 75501 BOWIE 11/03/2014 34%

163111101 1063411767 PARIS REGIONAL MEDICAL CENTER 820 CLARKSVILLE ST PARIS, TX 75460-6027 LAMAR 05/01/2016 34%

165552401 1710986385 PARIS REGIONAL MEDICAL CENTER REHAB UNIT 820 CLARKSVILLE ST PARIS, TX 75461-6027 LAMAR 09/01/2004 50%

127295703 1932123247 PARKLAND MEMORIAL HOSPITAL 5200 HARRY HINES BLVD DALLAS, TX 75235-7709 DALLAS 10/01/2016 36%

121811703 1780615880 PARK PLAZA HOSPITAL 1313 HERMANN DR HOUSTON, TX 77004-7005 HARRIS 01/01/2016 16%

111915801 1497708929 PARKVIEW REGIONAL HOSPITAL 600 SOUTH BONHAM STREET MEXIA, TX 76667-3603 LIMESTONE 08/01/2016 34%

137343308 1861475626 PARMER COUNTY COMMUNITY HOSPITAL 1307 CLEVELAND AVE FRIONA, TX 79035-1121 PARMER 10/01/2012 100%

137343308 1861475626 PARMER COUNTY COMMUNITY HOSPITAL 1307 CLEVELAND AVE FRIONA, TX 79035-1121 PARMER 11/01/2016 100%

130616905 1760598692 PECOS COUNTY MEMORIAL HOSP 387 WEST I-10 FORT STOCKTON, TX 79735-2700 PECOS 01/01/2016 58%

174662001 1316933609 PHYSICIANS MEDICAL CENTER LLC-TEXAS HEALTH CENTER FOR DIAGNOSTICS AND SURGERY PL6020 WEST PARKER ROAD PLANO, TX 75093-8171 COLLIN 12/01/2013 40%

165305701 1912948845 PHYSICIANS SURGICAL HOSPITALS LLC-QUAIL CREEK SURGICAL HOSPITAL 6819 PLUM CREEK DR AMARILLO, TX 79124-1602 POTTER 01/01/2015 42%

343467201 1659374585 PINE CREEK MEDICAL CENTER, LLC- 9032 HARRY HINES BLVD DALLAS, TX 75235-1720 DALLAS 09/01/2012 50%

361849801 1184089054 PINE VALLEY SPECIALTY HOSPITAL OPERATOR, LLC-PINE VALLEY SPECIALTY HOSPITAL 6160 SOUTH LOOP E HOUSTON, TX 77087 HARRIS 01/01/2016 89%

136142011 1033118716 PLAINS MEMORIAL HOSPITAL 310 WEST HALSELL DIMMITT, TX 79027-1846 CASTRO 05/01/2016 67%

353871201 1689068355 PLANO SPECIALTY HOSPITAL OPERATOR LLC-PLANO SPECIALTY HOSPITAL 1621 COIT RD PLANO, TX 75075 COLLIN 04/01/2015 42%

352444901 1851785521 PLUM CREEK SPECIALTY HOSPITAL OPERATOR LLC-PLUM CREEK SPECIALTY HOSPITAL 5601 PLUM CREEK DR AMARILLO, TX 79124 POTTER 04/01/2015 56%

199191101 1114962842 POST ACUTE MEDICAL AT LULING LLC-WARM SPRINGS SPECIALTY HOSPITAL OF LULING LLC 200 MEMORIAL DR LULING, TX 78648-3213 CALDWELL 12/01/2006 67%

199478201 1376588228 POST ACUTE MEDICAL AT SAN ANTONIO LLC-WARM SPRINGS REHABILITATION HOSPITAL OF SAN ANTONI5101 MEDICAL DR SAN ANTONIO, TX 78229-4801 BEXAR 06/01/2016 30%

199183801 1659316115 POST ACUTE MEDICAL AT VICTORIA LLC-PAM SPECIALTY HOSPITAL OF VICTORIA NORTH 102 MEDICAL DR VICTORIA, TX 77904-3101 VICTORIA 08/01/2007 68%

317151401 1689795098 POST ACUTE MEDICAL OF NEW BRAUNFELS LLC-WARM SPRINGS SPECIALTY HOSPITAL OF NEW BRAUNFELS 1445 HANZ DR NEW BRAUNFELS, TX 78130-2567 COMAL 09/01/2012 50%

329971101 1366874620 POST ACUTE SPECIALTY HOSPITAL OF CORPUS CHRISTI LL- 6226 SARATOGA BLVD CORPUS CHRISTI, TX 78414-3421 NUECES 09/01/2013 25%

331384301 1417389784 POST ACUTE SPECIALTY HOSPITAL OF VICTORIA LLC DBA-PAM SPECIALTY HOSPITAL OF VICTORIA SOUTH 506 E SAN ANTONIO ST FL 3 VICTORIA, TX 77901-6060 VICTORIA 09/25/2013 50%

316360201 1407121189 PREFERRED HOSPITAL LEASING COLEMAN INC- 310 S PECOS ST COLEMAN, TX 76834-4159 COLEMAN 10/01/2016 80%

179272301 1295764553 PREFERRED HOSPITAL LEASING ELDORADO INC-SCHLEICHER COUNTY MEDICAL CENTER 102 N US HIGHWAY 277 ELDORADO, TX 76936-4010 SCHLEICHER 12/01/2014 100%

200683501 1932379856 PREFERRED HOSPITAL LEASING HEMPHILL INC-SABINE COUNTY HOSPITAL 2301 HIGHWAY 83 WEST HEMPHILL, TX 75948-4159 SABINE 12/01/2014 100%

Created by HHSC Rate Analysis Division 8 11/16/2016

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

126840107 1477594299 PREFERRED HOSPITAL LEASING INC-COLLINGSWORTH GENERAL HOSPITAL 1013 15TH ST WELLINGTON, TX 79095 COLLINGSWORTH 10/01/2015 100%

206083201 1164688495 PREFERRED HOSPITAL LEASING JUNCTION INC-KIMBLE HOSPITAL 349 REID RD JUNCTION, TX 76849-3049 KIMBLE 04/01/2016 100%

350190001 1619368339 PREFERRED HOSPITAL LEASING MULESHOE INC-MULESHOE AREA MEDICAL CENTER 708 S 1ST ST MULESHOE, TX 79347-3627 BAILEY 10/01/2016 100%

176354201 1013970862 PREFERRED HOSPITAL LEASING VAN HORN INC-CULBERSON HOSPITAL EISENHOWER AND FM 2185 VAN HORN, TX 79855-0609 CULBERSON 03/01/2013 100%

121822403 1700805678 PRHC ENNIS LP-ENNIS REGIONAL MEDICAL CENTER 2201 WEST LAMPASAS ENNIS, TX 75119-5644 ELLIS 06/01/2016 23%

354018901 1790174860 PRIME HEALTHCARE SERVICES MESQUITE LLC-DALLAS REGIONAL MEDICAL CENTER 1011 N GALLOWAY AVE MESQUITE, TX 75149 DALLAS 01/01/2016 12%

315452801 1356615595 PRISTINE HEALTHCARE, LLC-PRISTINE HOSPITAL OF PASADENA 1004 SEYMOUR ST PASADENA, TX 77506-2637 HARRIS 12/11/2012 50%

340716501 1902237431 PROMISE HOSPITAL OF DALLAS INC- 7955 HARRY HINES BLVD BLD DALLAS, TX 75235-3305 DALLAS 03/18/2014 52%

338789601 1720419260 PROMISE HOSPITAL OF HOUSTON INC- 6160 SOUTH LOOP E HOUSTON, TX 77087-1010 HARRIS 06/01/2014 100%

339884401 1346671849 PROMISE HOSPITAL OF WICHITA FALLS INC- 1103 GRACE ST WICHITA FALLS, TX 76301-4414 WICHITA 03/17/2014 80%

111829102 1093708679 PROVIDENCE HEALTH SERVICES OF WACO-PROVIDENCE HEALTHCARE NETWORK 6901 MEDICAL PARKWAY WACO, TX 76712-7910 MCLENNAN 07/01/2016 37%

130601104 1700801909 PROVIDENCE MEMORIAL HOSPITAL 2001 NORTH OREGON EL PASO, TX 79902-3320 EL PASO 06/01/2016 14%

121799406 1295739258 RANKIN COUNTY HOSPITAL DISTRICT 1611 SPUR 576 RANKIN, TX 79778-0327 UPTON 12/01/2013 100%

121806703 1881697316 REAGAN MEMORIAL HOSPITAL 805 N MAIN AVE BIG LAKE, TX 76932-3938 REAGAN 03/01/2012 100%

112684904 1831170273 REEVES COUNTY HOSPITAL DISTRICT 2323 TEXAS ST PECOS, TX 79772-7338 REEVES 01/01/2016 86%

020991801 1942240189 REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT 107 SWIFT STREET REFUGIO, TX 78377-2425 REFUGIO 01/01/2015 100%

191816101 1205884491 REGENCY HOSPITAL OF FORT WORTH LLLP 6801 OAKMONT BLVD FORT WORTH, TX 76132-3918 TARRANT 07/23/2007 50%

179884501 1518905025 REHABCARE GROUP OF ARLINGTON LP-KINDRED REHABILITATION HOSPITAL ARLINGTON 2601 WEST RANDOL MILL ROAD STE 101 ARLINGTON, TX 76012-4216 TARRANT 02/24/2006 50%

212203801 1770740359 REHABILIATION INSTITUTE OF DENTON LLC-SELELCT REHABILITATIOIN HOSPITAL OF DENTON 2620 SCRIPTURE ST DENTON, TX 76201-4315 DENTON 04/03/2009 50%

218868201 1922321447 REHABILITATION HOSPITAL OF MESQUITE LLC-MESQUITE REHABILITATION INSTITUTE 1023 N BELT LINE RD MESQUITE, TX 75149-1788 DALLAS 11/03/2010 50%

315341301 1376829812 RELIANT REHABILITATION HOSPITAL NORTHWEST HOUSTON 20180 CHASEWOOD PARK DR HOUSTON, TX 77070-1436 HARRIS 05/14/2012 50%

343723801 1427472463 RESOLUTE HOSPITAL COMPANY LLC- 555 CREEKSIDE XING NEW BRAUNFELS, TX 78130-2594 COMAL 06/01/2016 72%

021170801 1891727475 RHSC EL PASO INC RIO VISTA 1740 CURIE DRIVE EL PASO, TX 79902-2901 EL PASO 06/01/2010 62%

021219301 1821161167 RIO GRANDE STATE CENTER-RIO GRANDE STATE CENTER 1401 S RANGERVILLE RD HARLINGEN, TX 78552-7638 CAMERON 10/01/2006 100%

112745802 1518937218 RIVER CREST HOSPITAL 1636 HUNTERS GLEN RD SAN ANGELO, TX 76901-5016 TOM GREEN 02/01/2006 25%

131040104 1689639254 RIVERSIDE GENERAL HOSPITAL 3204 ENNIS HOUSTON, TX 77004-3213 HARRIS 01/01/2015 100%

212468702 1417199225 RIVERVIEW BEHAVIORAL HEALTH LLC-VISTA HEALTH TEXARKANA 701 ARKANSAS BLVD TEXARKANA, AR 71854-2105 OUTOFSTATE 07/08/2010 80%

183086102 1306933692 ROCKDALE BLACKHAWK LLC-LITTLE RIVER HEALTHCARE 1700 BRAZOS AVE ROCKDALE, TX 76567-2517 MILAM 02/01/2016 88%

339869503 1184056954 ROCK SPRINGS, LLC- 700 SE INNER LOOP GEORGETOWN, TX 78626-7700 WILLIAMSON 06/25/2014 50%

193399601 1629138029 ROCKWALL REGIONAL HOSPITAL LLC-TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL 3150 HORIZON RD ROCKWALL, TX 75032-7805 ROCKWALL 01/01/2016 42%

133244705 1275581852 ROLLING PLAINS MEMORIAL HOSPITAL 200 E ARIZONA ST SWEETWATER, TX 79556-7120 NOLAN 10/01/2016 100%

301932503 1427278837 ROSEWOOD RANCH LP- 36075 S RINCON RD WICKENBURG, AZ 85390-2491 OUTOFSTATE 01/22/2012 50%

020957901 1649223645 ROUND ROCK HOSPITAL-ROUND ROCK MEDICAL CENTER 2400 ROUND ROCK AVE ROUND ROCK, TX 78681-4004 WILLIAMSON 08/01/2016 24%

133331202 1942218581 RUSK STATE HOSPITAL 1601 NORTH DICKINSON DRIVE RUSK, TX 75785-0318 CHEROKEE 06/01/2006 83%

127267603 1942294939 SAINT JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN, TX 77802-3867 BRAZOS 10/01/2016 21%

112693002 1194776104 SAN ANGELO COMMUNITY MEDICAL CENTER 3501 KNICKERBOCKER RD SAN ANGELO, TX 76904-7610 TOM GREEN 09/01/2016 24%

349059101 1871917971 SAN ANTONIO BEHAVIORAL HEALTHCARE HOSPITAL, LLC- 8550 HUEBNER RD SAN ANTONIO, TX 78240 BEXAR 01/22/2015 50%

138706004 1972511921 SAN ANTONIO STATE HOSPITAL 6711 S NEW BRAUNFELS, STE 100 SAN ANTONIO, TX 78223-3002 BEXAR 06/01/2006 78%

137962006 1891789772 SAN JACINTO METHODIST HOSPITAL-SAN JACINTO METHODIST HOSP 4401 GARTH RD BAYTOWN, TX 77521-2122 HARRIS 01/01/2016 27%

354215101 1720411713 SAS HEALTHCARE INC-SUNDANCE HOSPITAL DALLAS 2696 W WALNUT ST GARLAND, TX 75042 DALLAS 01/08/2015 80%

330147501 1053652438 SBH EL PASO LLC-PEAK BEHAVIORAL SERVICES LLC 5055 MCNUTT RD SANTA TERESA, NM 88008-9442 OUTOFSTATE 05/20/2013 80%

094212002 1538117452 SCA HOUSTON HOSPITAL FOR SPECIALIZED SURGERY LP-HOUSTON HOSPITAL FOR SPECIALIZED SURGERY 5445 LA BRANCH ST HOUSTON, TX 77004-6835 HARRIS 12/01/2005 100%

150967102 1013993559 SCCI HOSPITAL EL PASO INC-KINDRED HOSPITAL EL PASO 1740 CURIE DR EL PASO, TX 79902-2901 EL PASO 09/01/2011 54%

150967102 1013993559 SCCI HOSPITAL EL PASO INC-KINDRED HOSPITAL EL PASO 1740 CURIE DR EL PASO, TX 79902-2901 EL PASO 11/01/2016 21%

144752601 1881670339 SCCI HOSPITAL SAN ANGELO-TRIUMPH HOSPITAL SAN ANGELO 206 E. HARRIS SAN ANGELO, TX 76903-5904 TOM GREEN 09/01/2011 36%

131043506 1831160423 SCENIC MOUNTAIN MEDICAL CENTER 1601 W 11TH PL BIG SPRING, TX 79720-4114 HOWARD 02/01/2016 28%

326725404 1265772362 SCOTT AND WHITE HOSPITAL COLLEGE STATION-BAYLOR SCOTT & WHITE MEDICAL CENTER COLLEGE STATIO700 SCOTT AND WHITE DR COLLEGE STATION, TX 77845-6441 BRAZOS 07/01/2016 41%

220798701 1326349986 SCOTT AND WHITE HOSPITAL - LLANO-BAYLOR SCOTT AND WHITE MEDICAL CENTER - LLANO 200 W OLLIE ST LLANO, TX 78643-2628 LLANO 09/01/2016 56%

190123303 1265568638 SCOTT AND WHITE HOSPITAL ROUND ROCK-BAYLOR SCOTT & WHITE MEDICAL CENTER - ROUND ROCK 300 UNIVERSITY BLVD ROUND ROCK, TX 78665-1032 WILLIAMSON 06/01/2016 43%

136327710 1962497800 SCOTT AND WHITE HOSPITAL TAYLOR-BAYLOR SCOTT AND WHITE MEDICAL CENTER TAYLOR 305 MALLARD LN TAYLOR, TX 76574-1208 WILLIAMSON 04/01/2016 44%

137249208 1477516466 SCOTT AND WHITE MEMORIAL HOSPITAL-SCOTT AND WHITE MEDICAL CENTER - TEMPLE 2401 S 31ST ST TEMPLE, TX 76508-0001 BELL 09/01/2016 35%

135226205 1154315307 SCOTT & WHITE HOSPITAL BRENHAM-BAYLOR SCOTT AND WHITE MEDICAL CENTER BRENHAM 700 MEDICAL PKWY BRENHAM, TX 77833-5413 WASHINGTON 01/01/2016 50%

353712801 1396138970 SCOTT & WHITE HOSPITAL-MARBLE FALLS-BAYLOR SCOTT & WHITE MEDICAL CENTER-MARBLE FALLS 810 W HIGHWAY 71 MARBLE FALLS, TX 78654-8602 BURNET 09/17/2015 50%

136330112 1578588463 SCURRY COUNTY HOSPITAL DISTRICT-D.M. COGDELL MEMORIAL HOSPITAL 1700 COGDELL BLVD SNYDER, TX 79549-6162 SCURRY 02/01/2014 71%

Created by HHSC Rate Analysis Division 9 11/16/2016

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

021021301 1982603874 SELECT MEDICAL CORPORATION-SELECT SPECIALTY HOSPITAL HOUSTON 2130 W HOLCOMBE BLVD HOUSTON, TX 77030-3306 HARRIS 08/01/2013 36%

358597801 1184029811 SELECT SPECIALITY HOSPITAL-DALLAS, INC- 3500 GASTON AVE DALLAS, TX 75246-2017 DALLAS 07/01/2015 50%

361697101 1790189942 SELECT SPECIALTY HOSPITAL-DALLAS, INC 2300 MARIE CURIE DR GARLAND, TX 75042 DALLAS 07/01/2015 50%

194036301 1063411239 SELECT SPECIALTY HOSPITAL DALLAS INC-DALLAS SPECIALTY HOSPITAL DALLAS INC 2329 PARKER RD CARROLLTON, TX 75010-4713 DENTON 09/01/2004 50%

197824901 1861492670 SELECT SPECIALTY HOSPITAL LONGVIEW INC-SELECT SPECIALTY HOSPITAL LONGVIEW 700 E MARSHALL AVE LONGVIEW, TX 75601-5580 GREGG 01/01/2004 50%

201782401 1902806540 SELECT SPECIALTY HOSPITAL MIDLAND INC 4214 ANDREWS HIGHWAY 3RD FLOOR STE 32MIDLAND, TX 79703-4811 MIDLAND 09/01/2007 50%

196690501 1063412666 SELECT SPECIALTY HOSPITAL - SAN ANTONIO INC-SELECT SPECIALTY HOSPITAL SAN ANTONIO INC 111 DALLAS ST FL 4 SAN ANTONIO, TX 78205-1201 BEXAR 09/01/2004 50%

200157001 1518967074 SELECT SPECIALTY HOSPITAL- SOUTH DALLAS- 3500 W WHEATLAND AVE DALLAS, TX 75237 DALLAS 09/01/2006 50%

094153604 1356446686 SETON FAMILY OF HOSPITALS-SETON EDGAR B DAVIS HOSPITAL 130 HAYS ST LULING, TX 78648-3207 CALDWELL 07/01/2016 42%

094151004 1003833013 SETON FAMILY OF HOSPITALS-SETON HIGHLAND LAKES 3201 S WATER ST BURNET, TX 78611-4510 BURNET 07/01/2016 30%

135225404 1164526786 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER AUSTIN 1201 W 38TH ST AUSTIN, TX 78705-1006 TRAVIS 07/01/2016 23%

208013701 1619115383 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER HAYS 6001 KYLE PKWY KYLE, TX 78640-6112 HAYS 07/01/2016 23%

194106401 1578780870 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER WILLIAMSON 201 SETON PKWY ROUND ROCK, TX 78665-8000 WILLIAMSON 07/01/2016 22%

158980601 1124137054 SETON FAMILY OF HOSPITALS-SETON NORTHWEST HOSPITAL 11113 RESEARCH BLVD AUSTIN, TX 78759-5297 TRAVIS 09/01/2016 24%

286326801 1154612638 SETON FAMILY OF HOSPITALS-SETON SMITHVILLE REGIONAL HOSPITAL 1201 HILL RD SMITHVILLE, TX 78957-9533 BASTROP 07/01/2016 81%

158977201 1750499273 SETON FAMILY OF HOSPITALS-SETON SOUTHWEST HOSPITAL 7900 FM 1826 AUSTIN, TX 78737-1407 HAYS 07/01/2016 32%

137265806 1093810327 SETON FAMILY OF HOSPITALS-UNIVERSITY MEDICAL CENTER AT BRACKENRIDGE 601 E. 15TH ST AUSTIN, TX 78701-1930 TRAVIS 07/01/2016 27%

186599001 1447355771 SETON HEALTHCARE-DELL CHILDRENS MEDICAL CENTER OF CENTRAL TEXAS 4900 MUELLER BLVD AUSTIN, TX 78723-3079 TRAVIS 07/01/2016 23%

094382101 1538264866 SETON SHOAL CREEK HOSPITAL 3501 MILLS AVENUE AUSTIN, TX 78731-6309 TRAVIS 04/01/2006 67%

121193005 1538150370 SHAMROCK GENERAL HOSPITAL 1000 S MAIN ST SHAMROCK, TX 79079-2820 WHEELER 10/01/2016 100%

137226005 1992707228 SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO, TX 76903-5904 TOM GREEN 10/01/2016 33%

175965601 1861598633 SHC KPH LP-KINGWOOD PINES HOSPITAL 2001 LADBROOK, DR KINGWOOD, TX 77339-0000 HARRIS 10/01/2006 38%

220351501 1013957836 SHERMAN GRAYSON HOSPITAL LLC-WILSON N JONES REGIONAL MEMORIAL CENTER 500 N HIGHLAND AVE SHERMAN, TX 75092-7354 GRAYSON 02/01/2016 30%

298213401 1518000306 SHRINERS HOSPITAL FOR CHILDREN- 6977 MAIN ST HOUSTON, TX 77030-3701 HARRIS 01/01/2016 71%

293388901 1669513941 SHRINERS HOSPITALS FOR CHILDREN- 815 MARKET ST GALVESTON, TX 77550-2725 GALVESTON 01/01/2016 78%

127294003 1790782704 SID PETERSON MEMORIAL HOSPITAL-PETERSON REGIONAL MEDICAL CENTER 551 HILL COUNTRY DR KERRVILLE, TX 78028-6085 KERR 07/01/2016 45%

133245406 1215969787 SIERRA MEDICAL CENTER 1625 MEDICAL CENTER DR EL PASO, TX 79902-5005 EL PASO 06/01/2016 15%

181706601 1154361475 SJ MEDICAL CENTER LLC-ST JOSEPH MEDICAL CENTER 1401 ST JOSEPH PKWY HOUSTON, TX 77002-8301 HARRIS 01/01/2016 17%

181706601 1154361475 SJ MEDICAL CENTER LLC-ST JOSEPH MEDICAL CENTER 1401 ST JOSEPH PKWY HOUSTON, TX 77002-8301 HARRIS 11/01/2016 16%

190895601 1598710592 SOLARA HOSPITAL HARLINGEN 508 VICTORIA LANE HARLINGEN, TX 78550-3225 CAMERON 01/04/2007 50%

179881101 1568417392 SOLARA HOSPITAL MCALLEN- 301 W EXPRESSWAY 8TH FLOOR MCALLEN, TX 78503-3045 HIDALGO 05/01/2011 23%

216719901 1700826575 SOMERVELL COUNTY HOSPITAL DISTRICT-GLEN ROSE MEDICAL CENTER 1021 HOLDEN ST GLEN ROSE, TX 76043-4937 SOMERVELL 10/01/2015 59%

171461001 1629064928 SOUTHLAKE SPECIALTY HOSPITAL LLC-TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHLAKE 1545 SOUTHLAKE BLVD SOUTHLAKE, TX 76092-6422 TARRANT 01/01/2016 80%

094113001 1770573586 SOUTH TEXAS HEALTH SYSTEM 1102 WEST TRENTON RD EDINBURG, TX 78539-9105 HIDALGO 02/01/2016 15%

121780403 1184695785 SOUTH TEXAS REGIONAL MEDICAL CENTER 1905 HIGHWAY 97 E JOURDANTON, TX 78026-1504 ATASCOSA 08/01/2016 28%

173995501 1093712697 SOUTH TEXAS REHABILITATION HOSPITAL LP- 425 EAST ALTON GLOOR BROWNSVILLE, TX 78526-3361 CAMERON 06/01/2014 60%

136491104 1912906298 SOUTHWEST GENERAL HOSPITAL LP-SOUTHWEST GENERAL HOSPITAL 7400 BARLITE BLVD SAN ANTONIO, TX 78224-1308 BEXAR 10/01/2016 21%

352075101 1891193868 SRP OCEANS HOSPITAL OF KATY, LLC- 455 PARK GROVE LN KATY, TX 77450-1572 HARRIS 05/21/2015 50%

352273201 1376954263 SRP OCEANS HOSPITAL OF PLANO, LLC- 4301 MAPLESHADE PLANO, TX 75093 COLLIN 11/05/2014 50%

362439701 1184014433 SRP OCEANS HOSPITAL OF SAN MARCOS LLC-OCEANS BEHAVIORAL HOSPITAL OF SAN MARCOS 1106 N INTERSTATE 35 SAN MARCOS, TX 78666 HAYS 05/27/2016 80%

126842708 1649224825 STAMFORD MEMORIAL HOSPITAL- 1601 COLUMBIA ST STAMFORD, TX 79553-6863 JONES 12/01/2014 84%

136332705 1760567085 STARR COUNTY MEMORIAL HOSPITAL 128 N FM 3167 RIO GRANDE CITY, TX 78582-6211 STARR 10/01/2016 100%

094160103 1720033947 ST DAVIDS COMMUNITY HOSPITAL-ST DAVIDS MEDICAL CENTER 919 E 32ND ST AUSTIN, TX 78705-2703 TRAVIS 01/01/2015 25%

112717702 1679528889 ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP-SOUTH AUSTIN HOSPITAL 901 W. BEN WHITE BLVD AUSTIN, TX 78704-6903 TRAVIS 01/01/2016 20%

112717702 1679528889 ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP-SOUTH AUSTIN HOSPITAL 901 W. BEN WHITE BLVD AUSTIN, TX 78704-6903 TRAVIS 11/01/2016 18%

094216103 1629021845 ST DAVID'S HEALTHCARE PARTNERSHIP LP, LLP-ST DAVID'S NORTH AUSTIN MEDICAL CENTER 12221 N MO PAC EXPY AUSTIN, TX 78758-2401 TRAVIS 07/01/2016 17%

337991901 1285065623 STEPHENS MEMORIAL HOSPITAL- 200 S GENEVA ST BRECKENRIDGE, TX 76424-4702 STEPHENS 10/01/2016 89%

108895703 1992727663 ST LOUIS CHILDRENS HOSPITAL 1 CHILDRENS PL SAINT LOUIS, MO 63110-1002 OUTOFSTATE 04/24/2009 60%

298019501 1659559573 ST. LUKE'S COMMUNITY DEVELOPMENT CORPORATION-SUGAR-ST. LUKE'S SUGAR LAND HOSPITAL 1317 LAKE POINTE PKWY SUGAR LAND, TX 77478-3997 FORT BEND 07/01/2016 36%

160630301 1942208616 ST LUKES COMMUNITY HEALTH SERVICES-ST LUKES THE WOODLANDS HOSPITAL 17200 ST LUKE'S WAY THE WOODLANDS, TX 77384-8007 MONTGOMERY 07/01/2016 26%

339153401 1710314141 ST LUKES HOSPITAL AT THE VINTAGE- 20171 CHASEWOOD PARK DR HOUSTON, TX 77070-1437 HARRIS 09/01/2016 38%

339153401 1710314141 ST LUKES HOSPITAL AT THE VINTAGE- 20171 CHASEWOOD PARK DR HOUSTON, TX 77070-1437 HARRIS 11/01/2016 44%

210274101 1184868879 ST LUKES LAKESIDE HOSPITAL LLC-ST LUKES LAKESIDE HOSPITAL 17400 ST LUKES WAY THE WOODLANDS, TX 77384-8036 MONTGOMERY 07/01/2016 41%

281219001 1407990088 ST LUKES PATIENTS MEDICAL CENTER- 4600 E SAM HOUSTON PKWY S PASADENA, TX 77505-3948 HARRIS 07/01/2016 29%

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

176692501 1659362630 ST MARKS MEDICAL CENTER ONE ST MARK'S PLACE LA GRANGE, TX 78945-1250 FAYETTE 08/01/2016 68%

020992601 1083612121 STONEWALL MEMORIAL HOSPITAL DISTRICT-STONEWALL MEMORIAL HOSPITAL 821 N BROADWAY ASPERMONT, TX 79502-9023 STONEWALL 10/01/2016 100%

338014903 1568885549 STRATEGIC BH-ROCK PRAIRIE BEHAVIORAL HEALTH 3550 NOMAND DR COLLEGE STATION, TX 77845-6399 BRAZOS 06/10/2014 50%

335255101 1164665899 SUGAR LAND 24 HOUR HOSPITAL, LLC-EMERUS EMERGENCY HOSPITAL SUGAR LAND 16000 SOUTHWEST FWY STE 100 SUGAR LAND, TX 77479-2674 FORT BEND 01/01/2016 87%

283761901 1578878245 SUNDANCE HOSPITAL- 7000 US 287 HWY ARLINGTON, TX 76001-2805 TARRANT 07/23/2011 80%

361635101 1003282039 SUN HOUSTON, LLC- 7601 FANNIN ST HOUSTON, TX 77054-1905 HARRIS 04/19/2016 50%

020988401 1023011657 SWEENY COMMUNITY HOSPITAL 305 N MCKINNEY SWEENY, TX 77480-2801 BRAZORIA 09/01/2016 100%

316076401 1518253194 SWISHER MEMORIAL HEALTHCARE SYSTEM-SWISHER MEMORIAL HOSPITAL 539 SE 2ND ST TULIA, TX 79088-2400 SWISHER 01/01/2016 100%

126675104 1992753222 TARRANT COUNTY HOSPITAL DISTRICT-JPS HEALTH NETWORK 1500 S MAIN ST FORT WORTH, TX 76104-4917 TARRANT 11/01/2015 33%

169553801 1801826839 TENET FRISCO LTD 12505 LEBANON RD FRISCO, TX 75035-8298 COLLIN 01/01/2016 32%

196829901 1972709970 TENET HOSPITALS LIMITED-SIERRA PROVIDENCE EAST MEDICAL CENTER 3280 JOE BATTLE BLVD EL PASO, TX 79938-2622 EL PASO 01/01/2016 15%

137919003 1992713119 TERRELL STATE HOSPITAL 1200 E BRIN ST TERRELL, TX 75160-2938 KAUFMAN 06/01/2006 62%

130618504 1811916901 TERRY MEMORIAL HOSPITAL DISTRICT-BROWNFIELD REGIONAL MEDICAL CENTER 705 E FELT BROWNFIELD, TX 79316-3439 TERRY 09/01/2016 80%

139135109 1477643690 TEXAS CHILDRENS HOSPITAL 6621 FANNIN ST HOUSTON, TX 77030-2358 HARRIS 10/01/2016 34%

139135109 1477643690 TEXAS CHILDRENS HOSPITAL 6621 FANNIN ST HOUSTON, TX 77030-2358 HARRIS 11/01/2016 34%

318137201 1245523372 TEXAS GENERAL HOSPITAL- 2709 HOSPITAL BLVD GRAND PRAIRIE, TX 75051-1017 DALLAS 02/01/2016 15%

130614405 1174533343 TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL- 800 WEST RANDOL MILL ROAD ARLINGTON, TX 76012-2042 TARRANT 01/01/2016 34%

316296801 1215296884 TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE- 10864 TEXAS HEALTH TRL FORT WORTH, TX 76244-4897 TARRANT 07/01/2016 44%

127304703 1508899204 TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE- 108 DENVER TRAIL AZLE, TX 76020-3614 TARRANT 10/01/2016 28%

131036903 1396778064 TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE- 201 WALLS DR CLEBURNE, TX 76031-4007 JOHNSON 10/01/2016 33%

112677302 1336172105 TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH- 1301 PENNSYLVANIA AVE FORT WORTH, TX 76104-2122 TARRANT 11/01/2015 31%

112677302 1336172105 TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH- 1301 PENNSYLVANIA AVE FORT WORTH, TX 76104-2122 TARRANT 11/01/2016 29%

136326908 1104845015 TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST EULES- 1600 HOSPITAL PARKWAY BEDFORD, TX 76021-6913 TARRANT 10/01/2016 40%

120726804 1417980202 TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F- 6100 HARRIS PKWY FORT WORTH, TX 76132-4101 TARRANT 10/01/2016 32%

121794503 1922031541 TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILL- 411 N BELKNAP STEPHENVILLE, TX 76401-3415 ERATH 10/01/2016 42%

314080801 1033120423 TEXAS HEALTH HUGULEY HOSPITAL-TEXAS HEALTH HUGLEY FORT WORTH SOUTH 11801 SOUTH FWY BURLESON, TX 76028-7021 JOHNSON 04/01/2016 24%

020982701 1548291883 TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN- 1105 CENTRAL EXPY N ALLEN, TX 75013-3103 COLLIN 02/01/2016 67%

020967801 1003883158 TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON- 3000 I 35 NORTH DENTON, TX 76201-5119 DENTON 06/01/2016 34%

094140302 1457382798 TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN- 850 ED HALL DR KAUFMAN, TX 75142-1861 KAUFMAN 02/01/2016 46%

094207002 1770514077 TEXAS HEALTH PRESBYTERIAN HOSPTAL PLANO- 6200 W PARKER RD PLANO, TX 75093-7939 COLLIN 02/01/2016 37%

094205401 1730278417 TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH- 1301 PENNSYLVANIA AVE FORT WORTH, TX 76104-2122 TARRANT 09/01/2006 30%

185556101 1962504340 TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP-THE HEART HOSPITAL BAYLOR PLANO 1100 ALLIED DRIVE PLANO, TX 75093-5348 COLLIN 01/01/2016 33%

173574801 1245201656 TEXAS INSTITUTE FOR SURGERY LLP-TEXAS INSTITUTE FOR SURGERY AT TEXAS HEALTH PRESBY7115 GREENVILLE AVENUE STE 100 DALLAS, TX 75231-3623 DALLAS 05/01/2012 100%

021240902 1043280951 TEXAS LAUREL RIDGE HOSPITAL LP-LAUREL RIDGE TREATMENT CENTER 17720 CORPORATE WOODS DRIVE SAN ANTONIO, TX 78259-3500 BEXAR 09/01/2006 50%

333086201 1578809505 TEXAS OAKS PSYCHIATRIC HOSPITAL LP-AUSTIN OAKS HOSPITAL 1407 W STASSNEY LN AUSTIN, TX 78745-2947 TRAVIS 09/12/2013 50%

020908201 1396779948 TEXAS PRESBYTERIAN HOSPITAL OF DALLAS 8200 WALNUT HILL LN DALLAS, TX 75231-4426 DALLAS 02/01/2016 32%

209719801 1255579389 TEXAS REGIONAL MEDICAL CENTER LTD-TEXAS REGIONAL MEDICAL CENTER AT SUNNYVALE 231 S COLLINS RD SUNNYVALE, TX 75182-4624 DALLAS 01/01/2016 32%

209719801 1255579389 TEXAS REGIONAL MEDICAL CENTER LTD-TEXAS REGIONAL MEDICAL CENTER AT SUNNYVALE 231 S COLLINS RD SUNNYVALE, TX 75182-4624 DALLAS 11/01/2016 28%

315440301 1760628184 TEXAS SCOTTISH RITE HOSPITAL FOR CRIPPLED CHILDREN- 2222 WELBORN ST DALLAS, TX 75219-3924 DALLAS 06/01/2016 65%

315440301 1760628184 TEXAS SCOTTISH RITE HOSPITAL FOR CRIPPLED CHILDREN- 2222 WELBORN ST DALLAS, TX 75219-3924 DALLAS 11/01/2016 61%

162459501 1942292255 TEXAS SPINE AND JOINT HOSPITAL LTD 1814 ROSELAND BLVD TYLER, TX 75701-4262 SMITH 05/01/2016 24%

021017101 1043389034 THC HOUSTON INC-KINDRED HOSPITAL HOUSTON NORTHWEST 11297 FALLBROOK DR HOUSTON, TX 77065-4230 HARRIS 08/01/2008 20%

178795401 1043328198 THE HOSPITAL AT WESTLAKE MEDICAL CENTER 5656 BEE CAVES RD STE M302 WEST LAKE HILLS, TX 78746-5814 TRAVIS 12/01/2014 52%

127296503 1851347835 THE MEDICAL CENTER OF MESQUITE 1011 N GALLOWAY AVE MESQUITE, TX 75149-2433 DALLAS 11/01/2010 18%

163925401 1861467573 THE MEDICAL CENTER OF SOUTHEAST TEXAS LP- 2555 JIMMY JOHNSON BLVD PORT ARTHUR, TX 77640-2007 JEFFERSON 01/01/2016 20%

137949705 1548387418 THE METHODIST HOSPITAL 6565 FANNIN HOUSTON, TX 77030-2703 HARRIS 01/01/2016 23%

072362902 1356307581 THE NEBRASKA HEALTH SYSTEM-NEBRASKA MEDICAL CENTER 600 S 42ND ST OMAHA, NE 68198-7250 OUTOFSTATE 01/01/2008 60%

330388501 1194753590 THHBP MANAGEMENT COMPANY LLC-THE HEART HOSPITAL BAYLOR DENTON 2801 S MAYHILL RD DENTON, TX 76208-5910 DENTON 05/31/2013 45%

Created by HHSC Rate Analysis Division 11 11/16/2016

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

088189803 1356418974 THROCKMORTON COUNTY MEMORIAL HOSPITAL- 802 N MINTER AVE THROCKMORTON, TX 76483-5357 THROCKMORTON 01/01/2016 100%

138913209 1174526529 TITUS COUNTY MEM HOSP DIST-TITUS REGIONAL MEDICAL CENTER 2001 N JEFFERSON MT PLEASANT, TX 75455-2341 TITUS 10/01/2016 64%

138913215 1942373782 TITUS COUNTY MEM HOSP DIST-TITUS REGIONAL MEDICAL CENTER REHABILITATION UNIT 2001 N JEFFERSON MT PLEASANT, TX 75455-2341 TITUS 06/01/2009 48%

288051001 1407097231 TM VAN ZANDT HOSPITAL LLC-COZBY GERMANY HOSPITAL 707 N WALDRIP ST GRAND SALINE, TX 75140-1555 VAN ZANDT 11/01/2013 32%

340639901 1144651514 TOMBALL EXPRESS MEDICAL CENTER, LLC-EMERUS COMMUNITY HOSPITAL 24429 STATE HIGHWAY 249 TOMBALL, TX 77375-7877 HARRIS 07/18/2014 50%

288523801 1306126974 TOMBALL TEXAS HOSPITAL COMPANY- 605 HOLDERRIETH BLVD TOMBALL, TX 77375-6445 HARRIS 07/01/2016 23%

094208802 1144203662 TOPS SURGICAL SPECIALTY HOSP-TOPS SURGICAL SPECIALTY 17080 RED OAK DR HOUSTON, TX 77090-2602 HARRIS 12/01/2013 38%

021011401 1659440634 TRANSITIONAL HOSPITALS CORP-KINDRED HOSPITAL- TARRANT COUNTY 1000 N COOPER ST ARLINGTON, TX 76011-5540 TARRANT 06/01/2008 43%

184505902 1316911068 TRINITY MOTHER FRANCES REHABILITATION HOSPITAL 3131 TROUP HIGHWAY TYLER, TX 75701-8350 SMITH 03/01/2016 73%

149047601 1609876309 TRIUMPH HOSPITAL OF EAST HOUSTON LP-KINDRED HOSPITAL CLEAR LAKE 350 BLOSSOM ST WEBSTER, TX 77598-4206 HARRIS 11/01/2011 24%

094354003 1285626028 TRIUMPH HOSPITAL OF NORTH HOUSTON LP-KINDRED HOSPITAL TOMBALL 505 GRAHAM DR TOMBALL, TX 77375-3368 HARRIS 11/01/2011 39%

157708201 1689861593 TRIUMPH NORTHWEST LP-TRIUMPH HOSPITAL NORTHWEST 7407 NORTH FWY HOUSTON, TX 77076-1314 HARRIS 12/01/2010 100%

322878502 1417225434 TRIUMPH REHABILIATION HOSPITAL OF NORTHEAST HOUSTO-KINDRED REHABILITATION HOSPITAL NORTHEAST HOUSTON 18839 MCKAY DR HUMBLE, TX 77338-5721 HARRIS 09/01/2013 50%

157203401 1720088412 TRIUMPH SOUTHWEST LP-KINDRED HOSPITAL SUGAR LAND 1550 FIRST COLONY BLVD SUGAR LAND, TX 77479-4000 FORT BEND 09/01/2011 18%

172620001 1982609558 TROPHY CLUB MEDICAL CENTER LP 2850 EAST STATE HWY 114 TROPHY CLUB, TX 76262-1168 DENTON 09/01/2004 50%

172620001 1982609558 TROPHY CLUB MEDICAL CENTER LP 2850 EAST STATE HWY 114 TROPHY CLUB, TX 76262-1168 DENTON 01/01/2016 100%

178396101 1174524466 TYLER CONTINUE CARE HOSPITAL AT MOTHER FRANCES-TYLER CONTINUE CARE HOSPITAL AT MOTHER FRANCES HOS800 EAST DAWSON 4TH FLOOR TYLER, TX 75701-2036 SMITH 09/01/2011 10%

136381405 1447259627 TYLER COUNTY HOSPITAL 1100 W BLUFF WOODVILLE, TX 75979-4738 TYLER 07/01/2016 67%

177658501 1851346407 UHP LP 2026 WEST UNIVERSITY DRIVE DENTON, TX 76201-0644 DENTON 11/22/2005 80%

194997601 1851390967 UHS OF TEXOMA INC-TEXOMA MEDICAL CENTER 5016 S US HIGHWAY 75 DENISON, TX 75020-4584 GRAYSON 01/01/2016 35%

135237906 1023013448 UNITED REGIONAL HEALTHCARE 1600 11TH STREET WICHITA FALLS, TX 76301-4388 WICHITA 01/01/2016 31%

191968002 1386779304 UNIVERSITY BEHAVIORAL HEALTH OF EL PASO LLC 1900 DENVER AVE EL PASO, TX 79902-3008 EL PASO 03/05/2008 80%

137999206 1821087164 UNIVERSITY MEDICAL CENTER 602 INDIANA AVE LUBBOCK, TX 79415-3364 LUBBOCK 01/01/2016 27%

021187203 1578547667 UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUST-HARRIS COUNTY PSYCHIATRIC CENTER 2800 S MACGREGOR WAY HOUSTON, TX 77021-1032 HARRIS 08/04/2013 50%

127278304 1417941295 UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-UT HEALTH CENTER-TYLER 11937 US HIGHWAY 271 TYLER, TX 75708-3154 SMITH 09/01/2016 36%

094092602 1548226988 UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON-UNIVERSITY OF TEXAS MEDICAL BRANCH 301 UNIVERSITY BLVD RT 1076 GALVESTON, TX 77555-0001 GALVESTON 09/01/2016 39%

175287501 1285798918 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT-UNIVERSITY OF TEXAS SOUTHWESTERN UNIVERSITY HOSPTI6201 HARRY HINES DALLAS, TX 75390-0001 DALLAS 09/01/2016 44%

175289101 1417010653 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT-UTSOUTHWESTERN UNIVERSITY HOSPITAL ZALE LIPSHY 5151 HARRY HINES BLVD DALLAS, TX 75235-9000 DALLAS 09/01/2016 45%

162965101 1659352987 USMD HOSPITAL AT ARLINGTON LP 801 W INTERSTATE 20 ARLINGTON, TX 76017-5851 TARRANT 01/01/2016 28%

198248001 1568656502 USMD HOSPITAL AT FORT WORTH LP 5900 ALTAMESA BLVD FORT WORTH, TX 76132-5473 TARRANT 01/01/2016 25%

121782006 1740288505 UVALDE COUNTY HOSPITAL AUTHORITY-UVALDE MEMORIAL HOSPITAL 1025 GARNER FIELD RD UVALDE, TX 78801-4809 UVALDE 04/01/2015 65%

119877204 1104830900 VAL VERDE REGIONAL MEDICAL CENTER 801 N BEDELL AVE DEL RIO, TX 78840-4112 VAL VERDE 07/01/2016 52%

294543801 1184911877 VHS BROWNSVILLE HOSPITAL COMPANY LLC-VALLEY BAPTIST MEDICAL CENTER BROWNSVILLE 1040 W JEFFERSON ST BROWNSVILLE, TX 78520-6338 CAMERON 05/01/2016 17%

292096901 1154618742 VHS HARLINGEN HOSPITAL COMPANY LLC- 2101 PEASE ST HARLINGEN, TX 78550-8307 CAMERON 09/01/2016 22%

292096904 1568759991 VHS HARLINGEN HOSPITAL COMPANY LLC-VALLEY BAPTIST MEDICAL CENTER HARLINGEN 2101 PEASE ST HARLINGEN, TX 78550-8307 CAMERON 09/01/2013 22%

159156201 1598744856 VHS SAN ANTONIO PARTNERS LLC-BAPTIST HEALTH SYSTEM 111 DALLAS ST SAN ANTONIO, TX 78205-1201 BEXAR 07/01/2016 16%

159156204 1124007240 VHS SAN ANTONIO PARTNERS LLC-VHS SAN ANTONIO PARTNERS LP 111 DALLAS ST SAN ANTONIO, TX 78205-1201 BEXAR 02/01/2011 24%

334801301 1063844306 VIBRA HOSPITAL OF AMARILLO LLC DBA VIBRA HOSPITAL-VIBRA HOSPITAL OF AMARILLO 7501 WALLACE BLVD AMARILLO, TX 79124-2150 POTTER 09/01/2013 24%

334224803 1750713012 VIBRA REHABILITATION HOSPITAL OF AMARILLO LLC-VIBRA REHABILITATION HOSPITAL OF AMARILLO 7200 SW 9TH AVE AMARILLO, TX 79106-1703 POTTER 09/01/2013 50%

357697701 1740693316 VIBRA REHABILITATION HOSPITAL OF EL PASO, LLC-HIGHLANDS REHABILITATION HOSPITAL 1395 GEORGE DIETER DR EL PASO, TX 79936-7499 EL PASO 06/01/2016 82%

197976701 1477507432 VIBRA SPECIALTY HOSPITAL OF DALLAS LLC- 2700 WALKER WAY DESOTO, TX 75115-2088 DALLAS 08/01/2007 50%

020981901 1891718789 VISTA COMMUNITY MEDICAL CENTER HOSPITAL LLP-SURGERY SPECIALTY HOSPITAL OF AMERICA SE HOUSTON 4301 VISTA RD PASADENA, TX 77504-2117 HARRIS 05/01/2011 41%

109966502 1366450538 WACO CENTER FOR YOUTH 3501 N 19TH ST WACO, TX 76708-2007 MCLENNAN 06/01/2006 100%

189791001 1144225699 WALKER COUNTY HOSPITAL CORPORATION-HUNTSVILLE MEMORIAL HOSPITAL 110 MEMORIAL HOSPITAL DR HUNTSVILLE, TX 77342-4001 WALKER 08/01/2016 35%

341048201 1083056790 WALNUT HILL PHYSICIANS HOSPITAL LLC-WALNUT HILL MEDICAL CENTER 7502 GREENVILLE AVE DALLAS, TX 75231-3802 DALLAS 03/01/2016 73%

347731701 1861818809 WARM SPRINGS REHABILITATION HOSPITAL OF KYLE LLC- 5980 KYLE PKWY KYLE, TX 78640-2400 HAYS 09/08/2014 50%

350452401 1073952339 WARM SPRINGS REHABILITATION HOSPITAL OF VICTORIA L-PAM REHABILITATION HOSPITAL OF VICTORIA 101 JAMES COLEMAN DR VICTORIA, TX 77904-3147 VICTORIA 02/26/2015 50%

326690001 1629037163 WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO 7400 BARLITE BLVD FL 2ND SAN ANTONIO, TX 78224-1308 BEXAR 09/01/2013 50%

Created by HHSC Rate Analysis Division 12 11/16/2016

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TPI Provider NPI Provider Combined Name Physical Street Address Physical City, State, Zip CountyRate Effective

Date

Inpatient

Rate

(October)

184409401 1982781852 WEATHERFORD HOME CARE SERVICES LLC-WEATHERFORD REGIONAL MEDICAL CENTER 713 E ANDERSON STREET WEATHERFORD, TX 76086-5705 PARKER 01/01/2016 28%

184409401 1982781852 WEATHERFORD HOME CARE SERVICES LLC-WEATHERFORD REGIONAL MEDICAL CENTER 713 E ANDERSON STREET WEATHERFORD, TX 76086-5705 PARKER 11/01/2016 23%

359190101 1720407935 WEIMAR MEDICAL CENTER 400 YOUENS DR WEIMAR, TX 78962-3680 COLORADO 02/26/2016 50%

350453201 1538551791 WESLACO REGIONAL REHABILITATION HOSPITAL, LLC- 906 JAMES ST WESLACO, TX 78596-9840 HIDALGO 04/01/2012 68%

121829902 1598764359 WEST OAK HOSPITAL INC 6500 HORNWOOD DR HOUSTON, TX 77074-5008 HARRIS 10/01/2006 40%

344854001 1215354899 WESTPARK SPRINGS LLC- 6902 S PEEK RD RICHMOND, TX 77407-1741 FORT BEND 12/19/2014 50%

112707808 1316931835 WILBARGER COUNTY HOSPITAL DISTRICT-WILBARGER GENERAL HOSPITAL 920 HILLCREST DRIVE VERNON, TX 76384-3132 WILBARGER 10/01/2015 73%

135151206 1871599829 WILSON COUNTY MEMORIAL HOSPITAL DISTRICT-CONNALLY MEMORIAL MEDICAL CENTER 499 10TH STREET FLORESVILLE, TX 78114-3175 WILSON 11/01/2015 53%

135151206 1871599829 WILSON COUNTY MEMORIAL HOSPITAL DISTRICT-CONNALLY MEMORIAL MEDICAL CENTER 499 10TH STREET FLORESVILLE, TX 78114-3175 WILSON 11/01/2016 41%

094204701 1730183658 WINKLER COUNTY MEMORIAL HOSP 821 JEFFEE DR KERMIT, TX 79745-4610 WINKLER 12/01/2014 100%

148698701 1295781227 WINNIE COMMUNITY HOSPITAL LLC 538 BROADWAY WINNIE, TX 77665 CHAMBERS 01/01/2016 59%

130606006 1124076401 WISE REGIONAL HEALTH SYSTEM-WISE HEALTH SYSTEM 2000 SOUTH FM 51 DECATUR, TX 76234-3702 WISE 01/01/2016 46%

126667806 1104842475 W J MANGOLD MEMORIAL HOSPITAL 320 N MAIN ST LOCKNEY, TX 79241-0037 FLOYD 10/01/2016 100%

094164302 1487607792 WOODLAND HEIGHTS MEDICAL CENTER 505 S JOHN REDDITT DR LUFKIN, TX 75904-3159 ANGELINA 01/01/2016 18%

112673204 1881697878 YOAKUM COMMUNITY HOSPITAL 1200 CARL RAMBERT DR YOAKUM, TX 77995-4868 LAVACA 07/01/2016 88%

Created by HHSC Rate Analysis Division 13 11/16/2016