| Revenues | Service Code | Unit Type | Amount | Frequency | Unit Rate | Total Funding During Auth Period | ||
| Authorized Service | Unit Type | Amount | Frequency | Unit Rate | Cost | |||
| Expenses | Unit Type | Amount | Frequency | Pay Rate | Expense Type | Adjusted Rate | Expected Cost (Auth Period) | |
| Unallocated Dollars | ||||||||
| Total Expected Cost During Auth Period | ||||||||
Budget Calculator
Wisconsin Budget Tool
* This tool is for estimation of an individual budget and does not constitute an obligation on the part of GT Independence or Affiliates to fund or authorize services. This budget will be determined under the Budget Authority model which means that any adjustments in rate will modify available budget hours.
| Member Name: | ||
| Authorization Begin: | Authorization End: | Start Date: |