83 FR 43958 - Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 83, Issue 167 (August 28, 2018)
Federal Register Volume 83, Issue 167 (August 28, 2018)
| Page Range | 43958-43959 | |
| FR Document | 2018-18555 |
[Federal Register Volume 83, Number 167 (Tuesday, August 28, 2018)] [Notices] [Pages 43958-43959] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-18555] ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs AGENCY: Department of Veterans Affairs. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: This document updates the Cost-Based and Inter-Agency billing rates for medical care or services provided by the Department of Veterans Affairs (VA) furnished in certain circumstances. DATES: The rates set forth herein are effective August 28, 2018 and until further notice. FOR FURTHER INFORMATION CONTACT: Romona Greene, Office of Community Care, Revenue Operations, Payer Relations and Services, Rates and Charges (10D1C1), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 382-2521. (This is not a toll free number.) SUPPLEMENTARY INFORMATION: VA's methodology for computing Cost-Based and Inter-Agency rates for medical care or services provided by VA is set forth in 38 CFR 17.102(h). Two sets of rates are obtained by applying this methodology, Cost-Based and Inter-Agency. In accordance with 38 CFR 17.102(a), (b), (d), and (g) respectively, Cost-Based rates apply to medical care and services that are provided by VA:In error or based on tentative eligibility, In a medical emergency, To pensioners of allied nations; and For research purposes in circumstances under which the medical care appropriation shall be reimbursed from the research appropriation. In accordance with 38 CFR 17.102(c) and (f), Inter-Agency rates apply to medical care and services that are provided by VA to beneficiaries of the Department of Defense or other Federal agencies, when the care or services provided is not covered by an applicable sharing agreement, unless otherwise stated. The calculations for the Cost-Based and Inter-Agency rates are the same with two exceptions. Inter-Agency rates are all-inclusive, are not broken down into three components (Physician; Ancillary; and Nursing, Room, and Board), and do not include standard fringe benefit costs that cover Government employee retirement, disability costs, and return on fixed assets. When VA pays for medical care or services from a non-VA source under circumstances in which the Cost-Based or Inter-Agency rates would apply if the care or services had been provided by VA, the charge for such care or services will be the actual amount paid by VA for the care or services. Inpatient charges will be at the per diem rates shown for the type of bed section or discrete treatment unit providing the care. The following table depicts the Cost-Based and Inter-Agency rates that are effective upon publication of this notice and will remain in effect until the next Federal Register notice is published. These rates supersede those established by the Federal Register notice published on August, 29 2017, at 82 FR 41093. ------------------------------------------------------------------------ Inter-Agency Cost-Based rates rates ------------------------------------------------------------------------ A. Hospital Care per inpatient day: General Medicine: All Inclusive Rate.......... $4,025 $3,882 Physician................... 482 Ancillary................... 1,049 Nursing Room and Board...... 2,494 Neurology: All Inclusive Rate.......... 3,805 3,664 Physician................... 557 Ancillary................... 1,005 Nursing Room and Board...... 2,243 Rehabilitation Medicine: All Inclusive Rate.......... 2,749 2,641 Physician................... 312 Ancillary................... 840 Nursing Room and Board...... 1,597 [[Page 43959]] Blind Rehabilitation: All Inclusive Rate.......... 1,843 1,770 Physician................... 148 Ancillary................... 916 Nursing Room and Board...... 779 Spinal Cord Injury: All Inclusive Rate.......... 2,431 2,338 Physician................... 301 Ancillary................... 612 Nursing Room and Board...... 1,518 Surgery: All Inclusive Rate.......... 6,832 6,590 Physician................... 753 Ancillary................... 2,072 Nursing Room and Board...... 4,007 General Psychiatry: All Inclusive Rate.......... 1,993 1,913 Physician................... 188 Ancillary................... 314 Nursing Room and Board...... 1,491 Substance Abuse (Alcohol and Drug Treatment): All Inclusive Rate.......... 1,963 1,884 Physician................... 187 Ancillary................... 454 Nursing Room and Board...... 1,322 Psychosocial Residential Rehabilitation Program: All Inclusive Rate.......... 768 740 Physician................... 48 Ancillary................... 81 Nursing Room and Board...... 639 Intermediate Medicine: All Inclusive Rate.......... 2,483 2,388 Physician................... 122 Ancillary................... 364 Nursing Room and Board...... 1,997 Poly-trauma Inpatient: All Inclusive Rate.......... 3,113 2,981 Physician................... 354 Ancillary................... 951 Nursing Room and Board...... 1,808 B. Nursing Home Care, Per Day: All Inclusive Rate.............. 1,268 1,218 Physician....................... 39 Ancillary....................... 172 Nursing Room and Board.......... 1057 C. Outpatient Medical Treatments: Outpatient Visit (to include 362 350 Ineligible Emergency Dental Care).......................... Outpatient Physical Medicine & 223 213 Rehabilitation Service Visit... Outpatient Poly-trauma/Traumatic 602 580 Brain Injury................... ------------------------------------------------------------------------ Note: Outpatient Prescriptions will be billed at Drug Cost plus Administrative Fee. Signing Authority The Secretary of Veterans Affairs approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Robert L. Wilkie, Secretary, Department of Veterans Affairs, approved this document on August 22, 2018, for publication. Dated: August 22, 2018. Jeffrey M. Martin, Impact Analyst, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2018-18555 Filed 8-27-18; 8:45 am] BILLING CODE 8320-01-P
![43958 Federal Register / Vol. 83, No. 167 / Tuesday, August 28, 2018 / Notices
Abraham Lincoln National Cemetery additional information should contact rates apply to medical care and services
(20953 West Hoff Road, Elwood, IL Shannon L. Middleton at (202) 461– that are provided by VA:
60421). 6193, or 00W@mail.va.gov. • In error or based on tentative
On Thursday, September 13, the Dated: August 23, 2018. eligibility,
Committee will convene an open Jelessa M. Burney, • In a medical emergency,
session at the Jesse Brown VA Medical • To pensioners of allied nations; and
Federal Advisory Committee Management
Center; 820 South Damen Avenue, Officer. • For research purposes in
Chicago, IL 60612, from 8:30 a.m. to circumstances under which the medical
[FR Doc. 2018–18626 Filed 8–27–18; 8:45 am]
3:00 p.m. in the Prescription Conference care appropriation shall be reimbursed
BILLING CODE 8320–01–P
Room JB 2446B (2nd Floor, Damen from the research appropriation.
Building). The agenda will include In accordance with 38 CFR 17.102(c)
overview briefings from the Jesse Brown DEPARTMENT OF VETERANS and (f), Inter-Agency rates apply to
VA Medical Center leadership on the AFFAIRS medical care and services that are
facilities, programs, demographics, provided by VA to beneficiaries of the
women Veterans programs, and other Cost-Based and Inter-Agency Billing Department of Defense or other Federal
services available for Veterans in Rates for Medical Care or Services agencies, when the care or services
Chicago. In the afternoon, the Provided by the Department of provided is not covered by an
Committee will reconvene a closed Veterans Affairs applicable sharing agreement, unless
session, as it tours the Jesse Brown VA otherwise stated.
Medical Center. AGENCY: Department of Veterans Affairs. The calculations for the Cost-Based
In the morning of Friday, September ACTION: Notice. and Inter-Agency rates are the same
14, the Committee will convene an open with two exceptions. Inter-Agency rates
SUMMARY: This document updates the
session at the Jesse Brown VA Medical are all-inclusive, are not broken down
Cost-Based and Inter-Agency billing
Center; 820 South Damen Avenue, into three components (Physician;
rates for medical care or services
Chicago, IL 60612, from 8:00 a.m. to Ancillary; and Nursing, Room, and
provided by the Department of Veterans
9:00 a.m. in the Prescription Conference Board), and do not include standard
Affairs (VA) furnished in certain
Room JB 2446B (2nd Floor, Damen fringe benefit costs that cover
circumstances.
Building), as it conducts an out-briefing Government employee retirement,
with leadership from the Jesse Brown DATES: The rates set forth herein are disability costs, and return on fixed
VA Medical Center / Edward Hines effective August 28, 2018 and until assets. When VA pays for medical care
Junior Hospital / Captain James A. further notice. or services from a non-VA source under
Lovell Federal Health Care Center / FOR FURTHER INFORMATION CONTACT: circumstances in which the Cost-Based
Chicago Regional Benefits Office / Romona Greene, Office of Community or Inter-Agency rates would apply if the
Abraham Lincoln National Cemetery. Care, Revenue Operations, Payer care or services had been provided by
The Committee will reconvene an open Relations and Services, Rates and VA, the charge for such care or services
session in the Prescription Conference Charges (10D1C1), Veterans Health will be the actual amount paid by VA
Room JB 2446B (2nd Floor, Damen Administration, Department of Veterans for the care or services. Inpatient
Building), as it participates in a town Affairs, 810 Vermont Avenue NW, charges will be at the per diem rates
hall meeting with the women Veterans Washington, DC 20420, (202) 382–2521. shown for the type of bed section or
and other stakeholders. The town hall (This is not a toll free number.) discrete treatment unit providing the
meeting will begin at 9:30 a.m. and end SUPPLEMENTARY INFORMATION: VA’s care.
promptly at 11:00 a.m. methodology for computing Cost-Based The following table depicts the Cost-
With the exception of the town hall and Inter-Agency rates for medical care Based and Inter-Agency rates that are
meeting, there will be no time for public or services provided by VA is set forth effective upon publication of this notice
comment during the meeting. Members in 38 CFR 17.102(h). Two sets of rates and will remain in effect until the next
of the public may submit written are obtained by applying this Federal Register notice is published.
statements for the Committee’s review methodology, Cost-Based and Inter- These rates supersede those established
to 00W@mail.va.gov, or by fax at (202) Agency. by the Federal Register notice
273–7092. Any member of the public In accordance with 38 CFR 17.102(a), published on August, 29 2017, at 82 FR
and media wishing to attend or seeking (b), (d), and (g) respectively, Cost-Based 41093.
Cost-Based Inter-Agency
rates rates
A. Hospital Care per inpatient day:
General Medicine:
All Inclusive Rate ............................................................................................................................... $4,025 $3,882
Physician ........................................................................................................................................... 482
Ancillary ............................................................................................................................................. 1,049
Nursing Room and Board ................................................................................................................. 2,494
Neurology:
All Inclusive Rate ............................................................................................................................... 3,805 3,664
daltland on DSKBBV9HB2PROD with NOTICES
Physician ........................................................................................................................................... 557
Ancillary ............................................................................................................................................. 1,005
Nursing Room and Board ................................................................................................................. 2,243
Rehabilitation Medicine:
All Inclusive Rate ............................................................................................................................... 2,749 2,641
Physician ........................................................................................................................................... 312
Ancillary ............................................................................................................................................. 840
Nursing Room and Board ................................................................................................................. 1,597
VerDate Sep<11>2014 20:00 Aug 27, 2018 Jkt 244001 PO 00000 Frm 00117 Fmt 4703 Sfmt 4703 E:\FR\FM\28AUN1.SGM 28AUN1](https://thefederalregister.org/doc/83_FR_44125/page/1.svg)
![Federal Register / Vol. 83, No. 167 / Tuesday, August 28, 2018 / Notices 43959
Cost-Based Inter-Agency
rates rates
Blind Rehabilitation:
All Inclusive Rate ............................................................................................................................... 1,843 1,770
Physician ........................................................................................................................................... 148
Ancillary ............................................................................................................................................. 916
Nursing Room and Board ................................................................................................................. 779
Spinal Cord Injury:
All Inclusive Rate ............................................................................................................................... 2,431 2,338
Physician ........................................................................................................................................... 301
Ancillary ............................................................................................................................................. 612
Nursing Room and Board ................................................................................................................. 1,518
Surgery:
All Inclusive Rate ............................................................................................................................... 6,832 6,590
Physician ........................................................................................................................................... 753
Ancillary ............................................................................................................................................. 2,072
Nursing Room and Board ................................................................................................................. 4,007
General Psychiatry:
All Inclusive Rate ............................................................................................................................... 1,993 1,913
Physician ........................................................................................................................................... 188
Ancillary ............................................................................................................................................. 314
Nursing Room and Board ................................................................................................................. 1,491
Substance Abuse (Alcohol and Drug Treatment):
All Inclusive Rate ............................................................................................................................... 1,963 1,884
Physician ........................................................................................................................................... 187
Ancillary ............................................................................................................................................. 454
Nursing Room and Board ................................................................................................................. 1,322
Psychosocial Residential Rehabilitation Program:
All Inclusive Rate ............................................................................................................................... 768 740
Physician ........................................................................................................................................... 48
Ancillary ............................................................................................................................................. 81
Nursing Room and Board ................................................................................................................. 639
Intermediate Medicine:
All Inclusive Rate ............................................................................................................................... 2,483 2,388
Physician ........................................................................................................................................... 122
Ancillary ............................................................................................................................................. 364
Nursing Room and Board ................................................................................................................. 1,997
Poly-trauma Inpatient:
All Inclusive Rate ............................................................................................................................... 3,113 2,981
Physician ........................................................................................................................................... 354
Ancillary ............................................................................................................................................. 951
Nursing Room and Board ................................................................................................................. 1,808
B. Nursing Home Care, Per Day:
All Inclusive Rate ...................................................................................................................................... 1,268 1,218
Physician .................................................................................................................................................. 39
Ancillary .................................................................................................................................................... 172
Nursing Room and Board ......................................................................................................................... 1057
C. Outpatient Medical Treatments:
Outpatient Visit (to include Ineligible Emergency Dental Care) ............................................................... 362 350
Outpatient Physical Medicine & Rehabilitation Service Visit ................................................................... 223 213
Outpatient Poly-trauma/Traumatic Brain Injury ........................................................................................ 602 580
Note: Outpatient Prescriptions will be billed at Drug Cost plus Administrative Fee.
Signing Authority Register for publication electronically as Dated: August 22, 2018.
an official document of the Department Jeffrey M. Martin,
The Secretary of Veterans Affairs of Veterans Affairs. Robert L. Wilkie, Impact Analyst, Office of Regulation Policy
approved this document and authorized Secretary, Department of Veterans & Management, Office of the Secretary,
the undersigned to sign and submit the Affairs, approved this document on Department of Veterans Affairs.
document to the Office of the Federal August 22, 2018, for publication. [FR Doc. 2018–18555 Filed 8–27–18; 8:45 am]
BILLING CODE 8320–01–P
daltland on DSKBBV9HB2PROD with NOTICES
VerDate Sep<11>2014 20:00 Aug 27, 2018 Jkt 244001 PO 00000 Frm 00118 Fmt 4703 Sfmt 9990 E:\FR\FM\28AUN1.SGM 28AUN1](https://thefederalregister.org/doc/83_FR_44125/page/2.svg)
Document Created: 2018-08-28 00:23:35
Document Modified: 2018-08-28 00:23:35
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | The rates set forth herein are effective August 28, 2018 and until further notice. | |
| Contact | Romona Greene, Office of Community Care, Revenue Operations, Payer Relations and Services, Rates and Charges (10D1C1), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 382-2521. (This is not a toll free number.) | |
| FR Citation | 83 FR 43958 |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR