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Schedule of Charges

Matthew 25 follows HRSA Ryan White legislation based on Public Health Service Act Sections 2605 (e), 2617 (c), and 2664 (e)(1)(B)(ii).

Matthew 25 is required to impose a charge of a nominal fee for Ryan White HIV/AIDS Program patients whose individual income is greater than 100% of the current Federal Poverty Guidelines (FPL).

Matthew 25 uses the following schedule of charges to impose a nominal fee based on the current FPL for those RWHAP patients without health insurance. Health insurance will be billed charges based on a fee schedule for those RWHAP patients with health insurance thus meeting the standard that Ryan White grants are payer of last resort. Proof of income is required in order to assess individual FPL status for schedule assignment.

Our Schedule of Charges

FPL0-100%101-150%151-200%201-250%251-300%301 +%
Patient % of Charges0%20%40%60%80%100%
Discount on charges100%80%60%40%20%0%

Cap on Charges

Matthew 25 follows legislation of Cap on Charges based on individual income. Cap on Charges is a limitation on aggregate charges imposed during a calendar year based on RWHAP patient’s individual annual gross income. All fees are waived once the limit on the annual aggregate charges is reached for that calendar year. For Matthew 25 purposes, annual gross income refers to income earned during the calendar year.

Charges allowable to be applied to the RWHAP patient’s cap on charges can be:

  • Any charge for services with assistance under the grant for which a distinct fee is typically billed in the local health care market imposed by Matthew 25, or other RWHAP providers;
  • Or any charge for HIV related care to the extent the charge is in the context of (or as a result of) a HRSA RWHAP service.
    • Patient out of pocket charges related to HIV care reported to Matthew 25.

In order to determine annual cap status, proof of income is required at first appointment and annually thereafter. It is your responsibility to provide Matthew 25 with copies of statements, bills or receipts.

The current Federal Poverty Level Guideline is used to determine eligibility status for the programs offered. The guideline is listed below:

  • If your annual gross income is less than or equal to 100% of the Federal Poverty Guidelines you will not be charged for Early Intervention Services.
  • If your annual gross income is greater than 100% but less than 200%, you will not be charged an amount greater than 5% of your annual gross income for the calendar year.
  • If your annual gross income is greater than 200% but less than 300%, you will not be charged an amount greater than 7% of your annual gross income for the calendar year.
  • If your annual gross income is greater than 300%, you will not be charged greater than 10% of your gross income for the calendar year.