Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs for Fiscal Year 2021, 45471-45473 [2020-16323]
Download as PDF
<![CDATA[
Federal Register / Vol. 85, No. 145 / Tuesday, July 28, 2020 / Notices
Committee name
Committee description
Rehabilitation Research and Development Service Scientific Merit Review
Board.
Provides advice on the fair and equitable selection of the most meritorious research projects for support by VA research funds; provides advice for research program officials on program priorities and policies; and ensures that
the VA Rehabilitation Research and Development program promotes functional independence and improves the quality of life for impaired and disabled Veterans.
The Secretary has also renewed the
charter for the following statutorily
authorized Federal advisory committee
Advisory Committee on Cemeteries and
Memorials.
Provides advice on the administration of national cemeteries, Soldiers’ lots and
plots, the selection of cemetery sites, the erection of appropriate memorials
and the adequacy of Federal burial benefits.
Provides advice on benefits and services to Veterans experiencing homelessness.
Provides advice on VA prosthetics programs and the rehabilitation research,
development, and evaluation of prosthetics technology; assesses VA programs that serve Veterans with spinal cord injury, blindness or vision impairment, loss of or loss of use of extremities, deafness or hearing impairment or
other serious incapacities.
Provides advice to the Secretary on the administration of benefits for Veterans
who are former prisoners of war and the needs of these Veterans, in the
areas of compensation, health care and rehabilitation.
Provides advice on all matters pertaining to geriatrics and gerontology ..............
Geriatrics and
Committee.
Gerontology
Advisory
FOR FURTHER INFORMATION CONTACT:
Jeffrey Moragne, Committee
Management Office, Department of
Veterans Affairs, Advisory Committee
Management Office (00AC), 810
Vermont Avenue NW, Washington, DC
20420; telephone 202–266–4660 or 202–
714–1578; or via email at
Jeffrey.Moragne@va.gov. To view a copy
of a VA Federal advisory committee
charters, please visit https://www.va.gov/
advisory.
Dated: July 22, 2020.
Jelessa M. Burney,
Federal Advisory Committee Management
Officer.
BILLING CODE P
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 2021
AGENCY:
U.S. Department of Veterans
Affairs.
ACTION:
Notice.
This document updates the
Cost-Based and Inter-Agency billing
rates for medical care or services
provided by the U.S. Department of
SUMMARY:
VerDate Sep<11>2014
16:43 Jul 27, 2020
Jkt 250001
Veterans Affairs (VA) furnished in
certain circumstances.
APPLICABLE DATE: The rates set forth
herein are effective October 1, 2020.
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; telephone: 202–
382–2521 (this is not a toll-free
number).
VA’s
methodology for computing Cost-Based
and Inter-Agency rates for medical care
or services provided by VA is set forth
in section 17.102(h) of title 38 Code of
Federal Regulations (CFR). Two sets of
rates are obtained by applying this
methodology, Cost-Based and InterAgency.
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:
• 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.
SUPPLEMENTARY INFORMATION:
[FR Doc. 2020–16256 Filed 7–27–20; 8:45 am]
April 21, 2020.
for a two-year period, beginning on the
date listed below:
Committee description
Advisory Committee on Former Prisoners of War.
khammond on DSKJM1Z7X2PROD with NOTICES
Charter renewed on
Committee name
Advisory Committee on Homeless Veterans.
Advisory Committee on Prosthetics and
Special-Disabilities Programs.
45471
PO 00000
Frm 00103
Fmt 4703
Sfmt 4703
Charter renewed on
April 21, 2020.
May 6, 2020.
May 26, 2020.
June 15, 2020.
July 9, 2020.
Inter-Agency rates apply to medical
care and services that are provided by
VA under § 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 § 17.102(e):
• To beneficiaries of the Department
of Defense or other Federal agencies;
and
• 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. 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 CostBased and Inter-Agency rates that are
E:\FR\FM\28JYN1.SGM
28JYN1
45472
Federal Register / Vol. 85, No. 145 / Tuesday, July 28, 2020 / Notices
effective October 1, 2020, 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
September 30, 2019, at 84 FR 51728.
khammond on DSKJM1Z7X2PROD with NOTICES
Cost-based
rates
A. Hospital Care per inpatient day
General Medicine:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Neurology:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Rehabilitation Medicine:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Blind Rehabilitation:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Spinal Cord Injury:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Surgery:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
General Psychiatry:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Substance Abuse (Alcohol and Drug Treatment):
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Psychosocial Residential Rehabilitation Program:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Intermediate Medicine:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
Poly-trauma Inpatient:
All Inclusive Rate .......................................................................................................................................
Physician ...................................................................................................................................................
Ancillary .....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
B. Nursing Home Care, Per Day
All Inclusive Rate ..............................................................................................................................................
Physician ..........................................................................................................................................................
Ancillary ............................................................................................................................................................
Nursing Room and Board .................................................................................................................................
C. Outpatient Medical Treatments
Outpatient Visit (to include Ineligible Emergency Dental Care) .......................................................................
Outpatient Physical Medicine & Rehabilitation Service Visit ...........................................................................
Outpatient Poly-trauma/Traumatic Brain Injury ................................................................................................
VerDate Sep<11>2014
16:43 Jul 27, 2020
Jkt 250001
PO 00000
Frm 00104
Fmt 4703
Sfmt 4703
E:\FR\FM\28JYN1.SGM
28JYN1
Inter-agency
rates
$4,626
554
1,206
2,866
$4,473
........................
........................
........................
4,433
649
1,170
2,614
4,280
........................
........................
........................
3,090
351
944
1,795
2,979
........................
........................
........................
2,073
167
1,030
876
1,998
........................
........................
........................
3,032
376
763
1,893
2,924
........................
........................
........................
8,205
904
2,489
4,812
7,935
........................
........................
........................
2,403
227
378
1,798
2,314
........................
........................
........................
2,327
222
538
1,567
2,240
........................
........................
........................
306
19
32
255
297
........................
........................
........................
3,029
149
444
2,436
2,928
........................
........................
........................
3,303
375
1,009
1,919
3,165
........................
........................
........................
1,504
47
203
1,254
1,450
........................
........................
........................
409
241
643
396
231
622
Federal Register / Vol. 85, No. 145 / Tuesday, July 28, 2020 / Notices
Signing Authority
The Secretary of Veterans Affairs, or
designee, 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.
Brooks D. Tucker, Acting Chief of Staff,
Department of Veterans Affairs,
45473
approved this document on July 22,
2020 for publication.
Luvenia Potts,
Regulation Development Coordinator, Office
of Regulation Policy & Management, Office
of the Secretary, Department of Veterans
Affairs.
[FR Doc. 2020–16323 Filed 7–27–20; 8:45 am]
khammond on DSKJM1Z7X2PROD with NOTICES
BILLING CODE 8320–01–P
VerDate Sep<11>2014
16:43 Jul 27, 2020
Jkt 250001
PO 00000
Frm 00105
Fmt 4703
Sfmt 9990
E:\FR\FM\28JYN1.SGM
28JYN1
]]>Agencies
[Federal Register Volume 85, Number 145 (Tuesday, July 28, 2020)]
[Notices]
[Pages 45471-45473]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-16323]
-----------------------------------------------------------------------
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
2021
AGENCY: U.S. 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 U.S. Department of
Veterans Affairs (VA) furnished in certain circumstances.
APPLICABLE DATE: The rates set forth herein are effective October 1,
2020.
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;
telephone: 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 section 17.102(h) of title 38 Code of Federal Regulations
(CFR). 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:
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.
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):
To beneficiaries of the Department of Defense or other
Federal agencies; and
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. 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
[[Page 45472]]
effective October 1, 2020, 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 September 30,
2019, at 84 FR 51728.
------------------------------------------------------------------------
Cost-based Inter-agency
rates rates
------------------------------------------------------------------------
A. Hospital Care per inpatient day
General Medicine:
All Inclusive Rate.............. $4,626 $4,473
Physician....................... 554 ..............
Ancillary....................... 1,206 ..............
Nursing Room and Board.......... 2,866 ..............
Neurology:
All Inclusive Rate.............. 4,433 4,280
Physician....................... 649 ..............
Ancillary....................... 1,170 ..............
Nursing Room and Board.......... 2,614 ..............
Rehabilitation Medicine:
All Inclusive Rate.............. 3,090 2,979
Physician....................... 351 ..............
Ancillary....................... 944 ..............
Nursing Room and Board.......... 1,795 ..............
Blind Rehabilitation:
All Inclusive Rate.............. 2,073 1,998
Physician....................... 167 ..............
Ancillary....................... 1,030 ..............
Nursing Room and Board.......... 876 ..............
Spinal Cord Injury:
All Inclusive Rate.............. 3,032 2,924
Physician....................... 376 ..............
Ancillary....................... 763 ..............
Nursing Room and Board.......... 1,893 ..............
Surgery:
All Inclusive Rate.............. 8,205 7,935
Physician....................... 904 ..............
Ancillary....................... 2,489 ..............
Nursing Room and Board.......... 4,812 ..............
General Psychiatry:
All Inclusive Rate.............. 2,403 2,314
Physician....................... 227 ..............
Ancillary....................... 378 ..............
Nursing Room and Board.......... 1,798 ..............
Substance Abuse (Alcohol and Drug
Treatment):
All Inclusive Rate.............. 2,327 2,240
Physician....................... 222 ..............
Ancillary....................... 538 ..............
Nursing Room and Board.......... 1,567 ..............
Psychosocial Residential
Rehabilitation Program:
All Inclusive Rate.............. 306 297
Physician....................... 19 ..............
Ancillary....................... 32 ..............
Nursing Room and Board.......... 255 ..............
Intermediate Medicine:
All Inclusive Rate.............. 3,029 2,928
Physician....................... 149 ..............
Ancillary....................... 444 ..............
Nursing Room and Board.......... 2,436 ..............
Poly-trauma Inpatient:
All Inclusive Rate.............. 3,303 3,165
Physician....................... 375 ..............
Ancillary....................... 1,009 ..............
Nursing Room and Board.......... 1,919 ..............
B. Nursing Home Care, Per Day
All Inclusive Rate.................. 1,504 1,450
Physician........................... 47 ..............
Ancillary........................... 203 ..............
Nursing Room and Board.............. 1,254 ..............
C. Outpatient Medical Treatments
Outpatient Visit (to include 409 396
Ineligible Emergency Dental Care)..
Outpatient Physical Medicine & 241 231
Rehabilitation Service Visit.......
Outpatient Poly-trauma/Traumatic 643 622
Brain Injury.......................
------------------------------------------------------------------------
[[Page 45473]]
Signing Authority
The Secretary of Veterans Affairs, or designee, 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. Brooks D.
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved
this document on July 22, 2020 for publication.
Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy &
Management, Office of the Secretary, Department of Veterans Affairs.
[FR Doc. 2020-16323 Filed 7-27-20; 8:45 am]
BILLING CODE 8320-01-P
