Notice2022-19739
Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs for Fiscal Year 2023
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 13, 2022
Effective
October 1, 2022
Issuing agencies
Veterans Affairs Department
Abstract
This document updates the Cost-Based and Inter-Agency billing rates for medical care or services provided by the U.S. Department of Veterans Affairs (VA) furnished in certain circumstances.
Full Text
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<title>Federal Register, Volume 87 Issue 176 (Tuesday, September 13, 2022)</title>
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[Federal Register Volume 87, Number 176 (Tuesday, September 13, 2022)]
[Notices]
[Pages 56152-56153]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-19739]
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DEPARTMENT OF VETERANS AFFAIRS
Cost-Based and Inter-Agency Billing Rates for Medical Care or
Services Provided by the Department of Veterans Affairs for Fiscal Year
2023
AGENCY: Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: This document updates the Cost-Based and Inter-Agency billing
rates for medical care or services provided by the U.S. Department of
Veterans Affairs (VA) furnished in certain circumstances.
DATES: The rates set forth herein are effective October 1, 2022.
FOR FURTHER INFORMATION CONTACT: Ms. Debra Vatthauer, Office of
Finance, Revenue Operations, Payer Relations and Services, Rates and
Charges (104RO1), Veterans Health Administration, Department of
Veterans Affairs, 128 Bingham Road, Suite 1000, Asheville, NC 28806;
telephone: 608-821-7346 (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.
Cost-Based rates apply to medical care and services that are
provided by VA under 38 CFR 17.102(a), (b), (d) and (g), respectively,
in the following circumstances:
<bullet> In error or based on tentative eligibility;
<bullet> In a medical emergency;
<bullet> To pensioners of allied nations; and
<bullet> For research purposes in circumstances under which the
medical care appropriation shall be reimbursed from the research
appropriation.
Inter-Agency rates apply to medical care and services that are
provided by VA under Sec. 17.102(c) and (f), respectively, in the
following circumstances when the care or services provided are not
covered by any applicable sharing agreement in accordance with Sec.
17.102(e):
<bullet> To beneficiaries of the Department of Defense or other
Federal agencies; and
<bullet> To military retirees with chronic disability.
The calculations for the Cost-Based and Inter-Agency rates are the
same with two exceptions. Inter-Agency rates are all-inclusive and are
not broken down into three components (i.e., 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.
The following table depicts the Cost-Based and Inter-Agency rates
that are effective October 1, 2022, and will remain in effect until the
next fiscal year Federal Register update. These rates supersede those
established by the Federal Register notice published on August 4, 2021,
at 86 FR 42015.
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Cost-based Inter-agency
rates rates
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A. Hospital Care per inpatient day:
General Medicine:
All Inclusive Rate.............. $5,724 $5,630
Physician....................... 685 ..............
Ancillary....................... 1,492 ..............
Nursing Room and Board.......... 3,547 ..............
Neurology:
All Inclusive Rate.............. 4,969 4,885
Physician....................... 727 ..............
Ancillary....................... 1,312 ..............
Nursing Room and Board.......... 2,930 ..............
Rehabilitation Medicine:
All Inclusive Rate.............. 4,254 4,179
Physician....................... 483 ..............
Ancillary....................... 1,300 ..............
Nursing Room and Board.......... 2,471 ..............
Blind Rehabilitation:
All Inclusive Rate.............. 4,249 4,171
Physician....................... 342 ..............
Ancillary....................... 2,111 ..............
[[Page 56153]]
Nursing Room and Board.......... 1,796 ..............
Spinal Cord Injury:
All Inclusive Rate.............. 4,396 4,318
Physician....................... 545 ..............
Ancillary....................... 1,106 ..............
Nursing Room and Board.......... 2,745 ..............
Surgery:
All Inclusive Rate.............. 9,923 9,761
Physician....................... 1,094 ..............
Ancillary....................... 3,010 ..............
Nursing Room and Board.......... 5,819 ..............
General Psychiatry:
All Inclusive Rate.............. 3,575 3,510
Physician....................... 337 ..............
Ancillary....................... 563 ..............
Nursing Room and Board.......... 2,675 ..............
Substance Abuse (Alcohol and Drug
Treatment):
All Inclusive Rate.............. 3,631 3,565
Physician....................... 346 ..............
Ancillary....................... 840 ..............
Nursing Room and Board.......... 2,445 ..............
Psychosocial Residential
Rehabilitation Program:
All Inclusive Rate.............. 521 512
Physician....................... 33 ..............
Ancillary....................... 55 ..............
Nursing Room and Board.......... 433 ..............
Intermediate Medicine:
All Inclusive Rate.............. 3,906 3,841
Physician....................... 192 ..............
Ancillary....................... 573 ..............
Nursing Room and Board.......... 3,141 ..............
Poly-trauma Inpatient:
All Inclusive Rate.............. 4,765 4,673
Physician....................... 541 ..............
Ancillary....................... 1,456 ..............
Nursing Room and Board.......... 2,768 ..............
B. Nursing Home Care, Per Day:
All Inclusive Rate.............. 2,314 2,273
Physician....................... 72 ..............
Ancillary....................... 313 ..............
Nursing Room and Board.......... 1,929 ..............
C. Outpatient Medical Treatments:
Outpatient Visit (to include 453 446
Ineligible Emergency Dental
Care)..........................
Outpatient Physical Medicine & 366 359
Rehabilitation Service Visit...
Outpatient Poly-trauma/Traumatic 673 663
Brain Injury...................
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Note: Outpatient Prescriptions will be billed at Drug Cost plus
Administrative Fee.
Signing Authority
Denis McDonough, Secretary of Veterans Affairs, approved this
document on September 7, 2022, 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.
Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy &
Management, Office of the Secretary, Department of Veterans Affairs.
[FR Doc. 2022-19739 Filed 9-12-22; 8:45 am]
BILLING CODE 8320-01-P
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</html>Indexed from Federal Register on September 13, 2022.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.