Notices. Notice
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/register/2022/09/13/2022-19739·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
BILLING CODE 8320-01-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 2023 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 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: • 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 § 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. 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. Cost-based rates Inter-agency rates 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 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 Ineligible Emergency Dental Care) 453 446 Outpatient Physical Medicine & Rehabilitation Service Visit 366 359 Outpatient Poly-trauma/Traumatic Brain Injury 673 663 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]
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