Leaders at NYU Langone Health urged Gov. Kathy Hochul to craft congestion pricing exemptions for burdened patients and staff — a searing plea that went unheeded days later when she announced the hated Manhattan toll program’s return.

The letter sent Monday — and exclusively obtained by The Post — warned Hochul that NYU Langone patients and health care workers were uniquely positioned to suffer under congestion pricing.

The academic medical center along First Avenue is “deeply” embedded in the toll zone below 60th Street, with 70% of its patients living outside it, wrote Joseph Lhota, the system’s executive vice president — who previously served as Metropolitan Transportation Authority chair.

“We have heard directly from patients who are concerned about how congestion pricing will impact their ability to access our facilities for care,” he wrote. “(Congestion pricing) tolls are an expense that many patients cannot afford.”

But the congestion pricing revamp unveiled Thursday by Hochul — which would impose a $9 daytime base toll starting in the New Year — offers no such exemption, meaning Langone patients who drive will have to pay to make their appointments.

Lhota noted that taking public transportation is simply not an option for many patients.

“Particularly for immunocompromised individuals, those with mobility challenges, or those in urgent need of medical attention, the use of a vehicle is not a matter of choice but of necessity,” he wrote.

Langone patient Patrick Parker, 72, often drives into Manhattan from Bloomfield, New Jersey for his treatment four or five times a week – meaning he could face two sets of tolls to get to the hospital if he takes his car.

“I think it’s already so expensive to get into the city whether it’s public transportation or pay the tunnel fare, the bridge fare, whatever it is, and certainly people in the outer boroughs,” he told The Post Friday.

Parker said he understood the MTA’s need for funding, as well as the desire to unclog Manhattan’s streets of gridlock. 

But he said patients such as himself who live on Social Security and their pensions don’t need another cost eating into their fixed incomes.

“Patients should have an exemption,” he said. “There should be an exemption for certain people – people who have to come into the city for treatment and maybe they are not able to take public transportation, someone has to drive them because they are ill. I don’t think that they should be penalized for that.”

Likewise, Lhota also pressed for a toll exemption for Langone employees, noting nearly 20,000 live outside the congestion pricing zone south of 60th Street in Manhattan.

“While the majority of NYU Langone employees utilize public transportation, some employees drive to work for a variety of reasons, including a lack of public transportation where they live, incompatible transit schedules (particularly around overnight shifts) or because they are responding to an emergency while on call,” the letter states.

“As the only major academic medical center located in the heart of the Zone, Congestion Pricing could impact our ability to recruit and retain staff,” it continues. “This could exacerbate existing health care workforce challenges.”

A spokesperson for the governor said she “recognizes that many New Yorkers with health issues drive into Manhattan to see their doctor, which is one reason she insisted on making the toll 40% less expensive.”

“Recognizing the urgent need to provide transportation for those who need medical care, the governor recently deployed $52.1 million in funds that support transportation for senior citizens and people with disabilities,” the rep said in a statement Friday.

“Less congestion on Manhattan streets means ambulances will be able to quickly reach their destination, and anyone enrolled in Access-a-ride is exempt from paying this toll.”

— Additional reporting by Vaughn Golden