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SFY 2021 Hospital Provider Fee Payment Schedule

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SFY 2021 Hospital Provider Fee Payment Schedule Georgia Medicaid SFY 2021 Quarterly Hospital Provider Fee As of September 10, 2020 Annual 1st Qtr Due 2nd Qtr Due 3rd Qtr Due 4th Qtr Due UID Facility Name SFY 2021 9/30/20 12/31/20 3/31/21 6/30/21 Fee Amount HOSP412 Adventhealth Gordon $1,737,609 $434,403 $434,402 $434,402 $434,402 HOSP320 Adventhealth Murray $295,898 $73,975 $73,975 $73,974 $73,974 HOSP301 Appling Hospital $217,860 $54,465 $54,465 $54,465 $54,465 HOSP306 Burke Medical Center $116,686 $29,172 $29,172 $29,171 $29,171 HOSP626 Candler Hospital $3,936,909 $984,228 $984,227 $984,227 $984,227 HOSP542 Cartersville Medical Center $3,400,383 $850,095 $850,096 $850,096 $850,096 HOSP623 CHI Memorial Hospital Georgia $195,934 $48,983 $48,983 $48,984 $48,984 HOSP416 Children's Healthcare of Atlanta at Egleston $9,141,836 $2,285,459 $2,285,459 $2,285,459 $2,285,459 HOSP612 Children's Healthcare of Atlanta at Hughes Spalding $578,672 $144,668 $144,668 $144,668 $144,668 HOSP518 Children's Healthcare of Atlanta at Scottish Rite $8,397,225 $2,099,307 $2,099,306 $2,099,306 $2,099,306 HOSP406 Coffee Regional Medical Center $1,229,426 $307,357 $307,357 $307,356 $307,356 HOSP636 Coliseum Medical Centers $4,397,365 $1,099,342 $1,099,341 $1,099,341 $1,099,341 HOSP266 Coliseum Northside Hospital $1,743,753 $435,939 $435,938 $435,938 $435,938 HOSP524 Colquitt Regional Medical Center $1,555,153 $388,789 $388,788 $388,788 $388,788 HOSP922 Columbus Specialty Hospital $140,060 $35,015 $35,015 $35,015 $35,015 HOSP317 Cook Medical Center - A Campus of Tift Regional Medical Center $90,252 $22,563 $22,563 $22,563 $22,563 HOSP405 Crisp Regional Hospital $800,820 $200,205 $200,205 $200,205 $200,205 HOSP726 Doctor's Hospital of Augusta $5,927,892 $1,481,973 $1,481,973 $1,481,973 $1,481,973 HOSP309 Dodge County Hospital $280,509 $70,128 $70,127 $70,127 $70,127 HOSP310 Donalsonville Hospital, Inc. $402,857 $100,715 $100,714 $100,714 $100,714 HOSP501 Dorminy Medical Center $265,958 $66,489 $66,489 $66,490 $66,490 HOSP502 East Georgia Regional Medical Center $2,446,229 $611,558 $611,557 $611,557 $611,557 HOSP534 Eastside Medical Center $5,052,095 $1,263,023 $1,263,024 $1,263,024 $1,263,024 HOSP408 Emanuel Medical Center $276,632 $69,158 $69,158 $69,158 $69,158 HOSP720 Emory Decatur Hospital $4,552,328 $1,138,082 $1,138,082 $1,138,082 $1,138,082 HOSP902 Emory Hillandale Hospital $1,027,514 $256,878 $256,878 $256,879 $256,879 HOSP901 Emory Johns Creek Hospital $2,516,529 $629,133 $629,132 $629,132 $629,132 HOSP552 Emory Long Term Acute Care $226,937 $56,735 $56,734 $56,734 $56,734 HOSP778 Emory Rehabilitation Hospital $384,594 $96,149 $96,149 $96,148 $96,148 HOSP714 Emory Saint Joseph's Hospital of Atlanta $5,434,779 $1,358,694 $1,358,695 $1,358,695 $1,358,695 HOSP706 Emory University Hospital $13,370,051 $3,342,512 $3,342,513 $3,342,513 $3,342,513 HOSP705 Emory University Hospital Midtown $12,938,013 $3,234,504 $3,234,503 $3,234,503 $3,234,503 HOSP641 Emory University Hospital Smyrna $22,447 $5,611 $5,612 $5,612 $5,612 HOSP368 Emory University Orthopaedics & Spine Hospital $1,436,459 $359,114 $359,115 $359,115 $359,115 HOSP707 Encompass Health Rehab Hospital of Savannah $286,958 $71,739 $71,739 $71,740 $71,740 HOSP927 Encompass Health Rehabilitation Hospital of Newnan $343,156 $85,789 $85,789 $85,789 $85,789 HOSP448 Evans Memorial Hospital $143,398 $35,850 $35,850 $35,849 $35,849 HOSP510 Fairview Park Hospital $2,333,354 $583,339 $583,339 $583,338 $583,338 HOSP413 Fannin Regional Hospital $507,720 $126,930 $126,930 $126,930 $126,930 HOSP329 Flint River Community Hospital $101,004 $25,251 $25,251 $25,251 $25,251 HOSP606 Floyd Medical Center $4,817,869 $1,204,468 $1,204,467 $1,204,467 $1,204,467 HOSP351 Grady General Hospital $375,797 $93,950 $93,949 $93,949 $93,949 HOSP710 Grady Memorial Hospital $10,596,104 $2,649,026 $2,649,026 $2,649,026 $2,649,026 HOSP366 Gwinnett Medical Center $7,262,472 $1,815,618 $1,815,618 $1,815,618 $1,815,618 HOSP226 Gwinnett Medical Center - Duluth $2,332,873 $583,219 $583,218 $583,218 $583,218 HOSP414 Habersham County Medical Center $400,082 $100,020 $100,020 $100,021 $100,021 HOSP415 Hamilton Medical Center $3,366,128 $841,532 $841,532 $841,532 $841,532 HOSP439 Houston Medical Center $2,810,001 $702,501 $702,500 $702,500 $702,500 HOSP314 Irwin County Hospital $148,266 $37,067 $37,067 $37,066 $37,066 HOSP417 Jefferson Hospital $72,117 $18,030 $18,029 $18,029 $18,029 HOSP614 John D. Archbold Memorial Hospital $3,524,369 $881,093 $881,092 $881,092 $881,092 HOSP909 Landmark Hospital of Athens $231,324 $57,831 $57,831 $57,831 $57,831 HOSP776 Landmark Hospital of Savannah $318,411 $79,602 $79,603 $79,603 $79,603 HOSP443 Meadows Regional Medical Center $1,693,209 $423,303 $423,302 $423,302 $423,302 HOSP703 Memorial Health University Medical Center $6,745,519 $1,686,382 $1,686,379 $1,686,379 $1,686,379 HOSP539 Memorial Hospital of Bainbridge $387,091 $96,772 $96,773 $96,773 $96,773 HOSP627 Memorial Satilla Health $2,260,596 $565,149 $565,149 $565,149 $565,149 HOSP528 Navicent Health Baldwin $650,913 $162,729 $162,728 $162,728 $162,728 HOSP611 Northeast Georgia Medical Center $14,358,814 $3,589,703 $3,589,703 $3,589,704 $3,589,704 HOSP303 Northeast Georgia Medical Center Barrow $330,726 $82,681 $82,681 $82,682 $82,682 HOSP440 Northridge Medical Center $175,374 $43,843 $43,843 $43,844 $43,844 Georgia Medicaid SFY 2021 Quarterly Hospital Provider Fee As of September 10, 2020 Annual 1st Qtr Due 2nd Qtr Due 3rd Qtr Due 4th Qtr Due UID Facility Name SFY 2021 9/30/20 12/31/20 3/31/21 6/30/21 Fee Amount HOSP634 Northside Hospital $27,705,604 $6,926,401 $6,926,401 $6,926,401 $6,926,401 HOSP541 Northside Hospital Cherokee $4,125,592 $1,031,398 $1,031,398 $1,031,398 $1,031,398 HOSP346 Northside Hospital Forsyth $6,891,342 $1,722,835 $1,722,835 $1,722,836 $1,722,836 HOSP450 Perry Hospital $373,003 $93,250 $93,251 $93,251 $93,251 HOSP616 Phoebe Putney Memorial Hospital $6,783,075 $1,695,768 $1,695,769 $1,695,769 $1,695,769 HOSP602 Phoebe Sumter Medical Center $940,479 $235,119 $235,120 $235,120 $235,120 HOSP603 Piedmont Athens Regional Medical Center $6,001,565 $1,500,392 $1,500,391 $1,500,391 $1,500,391 HOSP704 Piedmont Columbus Regional Midtown $4,142,101 $1,035,526 $1,035,525 $1,035,525 $1,035,525 HOSP125 Piedmont Columbus Regional Northside $1,007,214 $251,803 $251,803 $251,804 $251,804 HOSP318 Piedmont Fayette Hospital $4,973,252 $1,243,313 $1,243,313 $1,243,313 $1,243,313 HOSP532 Piedmont Henry Hospital, Inc $3,884,135 $971,033 $971,034 $971,034 $971,034 HOSP617 Piedmont Hospital $13,899,571 $3,474,892 $3,474,893 $3,474,893 $3,474,893 HOSP451 Piedmont Mountainside Medical Center $1,146,125 $286,532 $286,531 $286,531 $286,531 HOSP629 Piedmont Newnan Hospital $3,180,449 $795,113 $795,112 $795,112 $795,112 HOSP322 Piedmont Newton Hospital $1,126,009 $281,503 $281,502 $281,502 $281,502 HOSP240 Piedmont Rockdale Hospital $1,270,766 $317,691 $317,691 $317,692 $317,692 HOSP340 Piedmont Walton Hospital $394,591 $98,647 $98,648 $98,648 $98,648 HOSP637 Redmond Regional Medical Center $4,301,367 $1,075,341 $1,075,342 $1,075,342 $1,075,342 HOSP906 Regency Hospital Company of Macon $405,242 $101,311 $101,311 $101,310 $101,310 HOSP917 Regency Hospital of South Atlanta $334,079 $83,519 $83,520 $83,520 $83,520 HOSP731 Rehabilitation Hospital, Navicent Health $269,880 $67,470 $67,470 $67,470 $67,470 HOSP619 Saint Francis Hospital $3,711,821 $927,956 $927,955 $927,955 $927,955 HOSP621 Saint Joseph's Hospital $3,104,220 $776,055 $776,055 $776,055 $776,055 HOSP923 Select Specialty Center - Savannah $268,516 $67,129 $67,129 $67,129 $67,129 HOSP544 Select Specialty Hospital - Midtown Atlanta, LLC $353,659 $88,414 $88,415 $88,415 $88,415 HOSP904 Select Specialty Hospital of Augusta $420,314 $105,079 $105,079 $105,078 $105,078 HOSP228 Shepherd Center $3,294,455 $823,613 $823,614 $823,614 $823,614 HOSP618 South Georgia Medical Center $4,318,148 $1,079,537 $1,079,537 $1,079,537 $1,079,537 HOSP445 South Georgia Medical Center - Berrien Campus $77,695 $19,423 $19,424 $19,424 $19,424 HOSP507 Southeast Georgia Health System - Brunswick Campus $3,846,360 $961,590 $961,590 $961,590 $961,590 HOSP441 Southeast Georgia Health System - Camden Campus $700,922 $175,230 $175,230 $175,231 $175,231 HOSP916 Southeastern Regional Medical Center, Inc $6,334,424 $1,583,606 $1,583,606 $1,583,606 $1,583,606 HOSP547 Southern Regional Medical Center $2,111,229 $527,808 $527,807 $527,807 $527,807 HOSP622 St Mary's Hospital $2,744,506 $686,127 $686,127 $686,126 $686,126 HOSP915 St.
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