-
Start Preamble
Start Printed Page 18466
AGENCY:
Department of Veterans Affairs.
ACTION:
Notice.
SUMMARY:
Section 17.101 of Title 38 of the Code of Federal Regulations sets forth the Department of Veterans Affairs (VA) medical regulations concerning “reasonable charges” for medical care or services provided or furnished by VA to a veteran:
—For a nonservice-connected disability for which the veteran is entitled to care (or the payment of expenses of care) under a health plan contract;
—For a nonservice-connected disability incurred incident to the veteran's employment and covered under a worker's compensation law or plan that provides reimbursement or indemnification for such care and services; or
—For a nonservice-connected disability incurred as a result of a motor vehicle accident in a State that requires automobile accident reparations insurance.
The regulations include methodologies for establishing billed amounts for the following types of charges: acute inpatient facility charges; skilled nursing facility/sub-acute inpatient facility charges; partial hospitalization facility charges; outpatient facility charges; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and other emergency transportation charges; and charges for durable medical equipment, drugs, injectables, and other medical services, items, and supplies identified by Healthcare Common Procedure Coding System (HCPCS) Level II codes. The regulations also provide that data for calculating actual charge amounts at individual VA facilities based on these methodologies will either be published in a notice in the Federal Register or will be posted on the Internet site of the Veterans Health Administration Chief Business Office, currently at http://www.va.gov/cbo, under “Charge Data.” Some of these charges are hereby updated as described in the SUPPLEMENTARY INFORMATION section of this notice. These changes are effective April 11, 2005.
When charges for medical care or services provided or furnished at VA expense by either VA or non-VA providers have not been established under other provisions of the regulations, the method for determining VA's charges is set forth at 38 CFR 17.101(a)(8).
Start Further InfoFOR FURTHER INFORMATION CONTACT:
Romona Greene, Chief Business Office (168), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, (202) 254-0361. (This is not a toll free number.)
End Further Info End Preamble Start Supplemental InformationSUPPLEMENTARY INFORMATION:
Of the charge types listed in the Summary section of this notice, acute inpatient facility charges and skilled nursing facility/sub-acute inpatient facility charges are not being changed. Acute inpatient facility charges remain the same as set forth in a notice published in the Federal Register on December 15, 2004 (69 FR 75111). Skilled nursing facility/sub-acute inpatient facility charges remain the same as set forth in a notice published in the Federal Register on December 15, 2004 (69 FR 75111).
Based on the methodologies set forth in 38 CFR 17.101, this document provides an update to charges for 2005 HCPCS Level II and Current Procedural Technology (CPT) codes. Charges are also being updated based on more recent versions of data sources for the following charge types: partial hospitalization facility charges; outpatient facility charges; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and other emergency transportation charges; and charges for durable medical equipment, drugs, injectables, and other medical services, items, and supplies identified by HCPCS Level II codes. These updated charges are effective April 11, 2005.
In this update, we are retaining the table designations used in the notice published in the Federal Register on April 15, 2004 (69 FR 20118). Accordingly, the tables identified as being updated by this notice correspond to the applicable tables published in the notice, beginning with Table C.
We have updated the list of data sources presented in Supplementary Table 1 to reflect the updated data sources used to establish the updated charges described in this notice.
As a reminder, in Supplementary Table 3 published in the Federal Register dated April 15, 2004, we set forth the list of VA medical facility locations, which includes their three-digit Zip Codes and provider based/non-provider based designations. In accordance with the final rule, subsequent updates to Supplementary Table 3 will be posted on the Internet site of the Veterans Health Administration Chief Business Office.
Consistent with the regulations, the updated data tables and supplementary tables containing the changes described are published with this notice. The updated data tables and supplementary tables containing the changes described will be effective until changed by a subsequent Federal Register notice.
Start SignatureApproved: February 14, 2005.End Signature Start Printed Page 18467 Start Printed Page 18468 Start Printed Page 18469 Start Printed Page 18470 Start Printed Page 18471 Start Printed Page 18472 Start Printed Page 18473 Start Printed Page 18474 Start Printed Page 18475 Start Printed Page 18476 Start Printed Page 18477 Start Printed Page 18478 Start Printed Page 18479 Start Printed Page 18480 Start Printed Page 18481 Start Printed Page 18482 Start Printed Page 18483 Start Printed Page 18484 Start Printed Page 18485 Start Printed Page 18486 Start Printed Page 18487 Start Printed Page 18488 Start Printed Page 18489 Start Printed Page 18490 Start Printed Page 18491 Start Printed Page 18492 Start Printed Page 18493 Start Printed Page 18494 Start Printed Page 18495 Start Printed Page 18496 Start Printed Page 18497 Start Printed Page 18498 Start Printed Page 18499 Start Printed Page 18500 Start Printed Page 18501 Start Printed Page 18502 Start Printed Page 18503 Start Printed Page 18504 Start Printed Page 18505 Start Printed Page 18506 Start Printed Page 18507 Start Printed Page 18508 Start Printed Page 18509 Start Printed Page 18510 Start Printed Page 18511 Start Printed Page 18512 Start Printed Page 18513 Start Printed Page 18514 Start Printed Page 18515 Start Printed Page 18516 Start Printed Page 18517 Start Printed Page 18518 Start Printed Page 18519 Start Printed Page 18520 Start Printed Page 18521 Start Printed Page 18522 Start Printed Page 18523 Start Printed Page 18524 Start Printed Page 18525 Start Printed Page 18526 Start Printed Page 18527 Start Printed Page 18528 Start Printed Page 18529 Start Printed Page 18530 Start Printed Page 18531 Start Printed Page 18532 Start Printed Page 18533 Start Printed Page 18534 Start Printed Page 18535 Start Printed Page 18536 Start Printed Page 18537 Start Printed Page 18538 Start Printed Page 18539 Start Printed Page 18540 Start Printed Page 18541 Start Printed Page 18542 Start Printed Page 18543 Start Printed Page 18544 Start Printed Page 18545 Start Printed Page 18546 Start Printed Page 18547 Start Printed Page 18548 Start Printed Page 18549 Start Printed Page 18550 Start Printed Page 18551 Start Printed Page 18552 Start Printed Page 18553 Start Printed Page 18554 Start Printed Page 18555 Start Printed Page 18556 Start Printed Page 18557 Start Printed Page 18558 Start Printed Page 18559 Start Printed Page 18560 Start Printed Page 18561 Start Printed Page 18562 Start Printed Page 18563 Start Printed Page 18564 Start Printed Page 18565 Start Printed Page 18566 Start Printed Page 18567 Start Printed Page 18568 Start Printed Page 18569 Start Printed Page 18570 Start Printed Page 18571 Start Printed Page 18572 Start Printed Page 18573 Start Printed Page 18574 Start Printed Page 18575 Start Printed Page 18576 Start Printed Page 18577 Start Printed Page 18578 Start Printed Page 18579 Start Printed Page 18580 Start Printed Page 18581 Start Printed Page 18582 Start Printed Page 18583 Start Printed Page 18584 Start Printed Page 18585 Start Printed Page 18586 Start Printed Page 18587 Start Printed Page 18588 Start Printed Page 18589 Start Printed Page 18590 Start Printed Page 18591 Start Printed Page 18592 Start Printed Page 18593 Start Printed Page 18594 Start Printed Page 18595 Start Printed Page 18596 Start Printed Page 18597 Start Printed Page 18598 Start Printed Page 18599 Start Printed Page 18600 Start Printed Page 18601 Start Printed Page 18602 Start Printed Page 18603 Start Printed Page 18604 Start Printed Page 18605 Start Printed Page 18606 Start Printed Page 18607 Start Printed Page 18608 Start Printed Page 18609 Start Printed Page 18610 Start Printed Page 18611 Start Printed Page 18612 Start Printed Page 18613 Start Printed Page 18614 Start Printed Page 18615 Start Printed Page 18616 Start Printed Page 18617 Start Printed Page 18618 Start Printed Page 18619 Start Printed Page 18620 Start Printed Page 18621 Start Printed Page 18622 Start Printed Page 18623 Start Printed Page 18624 Start Printed Page 18625 Start Printed Page 18626 Start Printed Page 18627 Start Printed Page 18628 Start Printed Page 18629 Start Printed Page 18630 Start Printed Page 18631 Start Printed Page 18632 Start Printed Page 18633 Start Printed Page 18634 Start Printed Page 18635 Start Printed Page 18636 Start Printed Page 18637 Start Printed Page 18638 Start Printed Page 18639 Start Printed Page 18640 Start Printed Page 18641 Start Printed Page 18642 Start Printed Page 18643 Start Printed Page 18644 Start Printed Page 18645 Start Printed Page 18646 Start Printed Page 18647 Start Printed Page 18648 Start Printed Page 18649 Start Printed Page 18650 Start Printed Page 18651 Start Printed Page 18652 Start Printed Page 18653 Start Printed Page 18654 Start Printed Page 18655 Start Printed Page 18656 Start Printed Page 18657 Start Printed Page 18658 Start Printed Page 18659 Start Printed Page 18660 Start Printed Page 18661 Start Printed Page 18662 Start Printed Page 18663 Start Printed Page 18664 Start Printed Page 18665 Start Printed Page 18666 Start Printed Page 18667 Start Printed Page 18668 Start Printed Page 18669 Start Printed Page 18670 Start Printed Page 18671 Start Printed Page 18672 Start Printed Page 18673 Start Printed Page 18674 Start Printed Page 18675 Start Printed Page 18676 Start Printed Page 18677 Start Printed Page 18678 Start Printed Page 18679 Start Printed Page 18680 Start Printed Page 18681 Start Printed Page 18682 Start Printed Page 18683 Start Printed Page 18684 Start Printed Page 18685 Start Printed Page 18686 Start Printed Page 18687 Start Printed Page 18688 Start Printed Page 18689 Start Printed Page 18690 Start Printed Page 18691 Start Printed Page 18692 Start Printed Page 18693 Start Printed Page 18694 Start Printed Page 18695 Start Printed Page 18696 Start Printed Page 18697 Start Printed Page 18698 Start Printed Page 18699 Start Printed Page 18700 Start Printed Page 18701 Start Printed Page 18702 Start Printed Page 18703 Start Printed Page 18704 Start Printed Page 18705 Start Printed Page 18706 Start Printed Page 18707 Start Printed Page 18708 Start Printed Page 18709 Start Printed Page 18710 Start Printed Page 18711 Start Printed Page 18712 Start Printed Page 18713 Start Printed Page 18714 Start Printed Page 18715 Start Printed Page 18716 Start Printed Page 18717 Start Printed Page 18718 Start Printed Page 18719 Start Printed Page 18720 Start Printed Page 18721 Start Printed Page 18722 Start Printed Page 18723 Start Printed Page 18724 Start Printed Page 18725 Start Printed Page 18726 Start Printed Page 18727 Start Printed Page 18728 Start Printed Page 18729 Start Printed Page 18730 Start Printed Page 18731 Start Printed Page 18732 Start Printed Page 18733 Start Printed Page 18734 Start Printed Page 18735 Start Printed Page 18736 Start Printed Page 18737 Start Printed Page 18738 Start Printed Page 18739 Start Printed Page 18740 Start Printed Page 18741 Start Printed Page 18742 Start Printed Page 18743 Start Printed Page 18744 Start Printed Page 18745 Start Printed Page 18746 Start Printed Page 18747 Start Printed Page 18748 Start Printed Page 18749 Start Printed Page 18750 Start Printed Page 18751 Start Printed Page 18752 Start Printed Page 18753 Start Printed Page 18754 Start Printed Page 18755 Start Printed Page 18756 Start Printed Page 18757 Start Printed Page 18758 Start Printed Page 18759 Start Printed Page 18760 Start Printed Page 18761 Start Printed Page 18762 Start Printed Page 18763 Start Printed Page 18764 Start Printed Page 18765 Start Printed Page 18766 Start Printed Page 18767 Start Printed Page 18768 Start Printed Page 18769 Start Printed Page 18770 Start Printed Page 18771 Start Printed Page 18772 Start Printed Page 18773 Start Printed Page 18774 Start Printed Page 18775 Start Printed Page 18776 Start Printed Page 18777 Start Printed Page 18778 Start Printed Page 18779 Start Printed Page 18780 Start Printed Page 18781 Start Printed Page 18782 Start Printed Page 18783 Start Printed Page 18784 Start Printed Page 18785 Start Printed Page 18786 Start Printed Page 18787 Start Printed Page 18788 Start Printed Page 18789 Start Printed Page 18790 Start Printed Page 18791 Start Printed Page 18792 Start Printed Page 18793 Start Printed Page 18794 Start Printed Page 18795 Start Printed Page 18796 Start Printed Page 18797 Start Printed Page 18798 Start Printed Page 18799 Start Printed Page 18800 Start Printed Page 18801 Start Printed Page 18802 Start Printed Page 18803 Start Printed Page 18804 Start Printed Page 18805 Start Printed Page 18806 Start Printed Page 18807 Start Printed Page 18808 Start Printed Page 18809 Start Printed Page 18810 Start Printed Page 18811 Start Printed Page 18812 Start Printed Page 18813 Start Printed Page 18814 Start Printed Page 18815 Start Printed Page 18816 Start Printed Page 18817 Start Printed Page 18818 Start Printed Page 18819 Start Printed Page 18820 Start Printed Page 18821 Start Printed Page 18822 Start Printed Page 18823 Start Printed Page 18824 Start Printed Page 18825 Start Printed Page 18826 Start Printed Page 18827 Start Printed Page 18828 Start Printed Page 18829 Start Printed Page 18830 Start Printed Page 18831 Start Printed Page 18832 Start Printed Page 18833 Start Printed Page 18834 Start Printed Page 18835 Start Printed Page 18836 Start Printed Page 18837 Start Printed Page 18838 Start Printed Page 18839 Start Printed Page 18840 Start Printed Page 18841 Start Printed Page 18842 Start Printed Page 18843 Start Printed Page 18844 Start Printed Page 18845 Start Printed Page 18846 Start Printed Page 18847 Start Printed Page 18848 Start Printed Page 18849 Start Printed Page 18850 Start Printed Page 18851 Start Printed Page 18852 Start Printed Page 18853 Start Printed Page 18854 Start Printed Page 18855 Start Printed Page 18856 Start Printed Page 18857 Start Printed Page 18858 Start Printed Page 18859 Start Printed Page 18860 Start Printed Page 18861 Start Printed Page 18862 Start Printed Page 18863 Start Printed Page 18864 Start Printed Page 18865 Start Printed Page 18866 Start Printed Page 18867 Start Printed Page 18868 Start Printed Page 18869 Start Printed Page 18870 Start Printed Page 18871 Start Printed Page 18872 Start Printed Page 18873 Start Printed Page 18874 Start Printed Page 18875 Start Printed Page 18876 Start Printed Page 18877 Start Printed Page 18878 Start Printed Page 18879 Start Printed Page 18880 Start Printed Page 18881 Start Printed Page 18882 Start Printed Page 18883 Start Printed Page 18884 Start Printed Page 18885 Start Printed Page 18886 Start Printed Page 18887 Start Printed Page 18888 Start Printed Page 18889 Start Printed Page 18890 Start Printed Page 18891 Start Printed Page 18892 Start Printed Page 18893 Start Printed Page 18894 Start Printed Page 18895 Start Printed Page 18896 Start Printed Page 18897 Start Printed Page 18898 Start Printed Page 18899 Start Printed Page 18900 Start Printed Page 18901 Start Printed Page 18902 Start Printed Page 18903 Start Printed Page 18904 Start Printed Page 18905 Start Printed Page 18906 Start Printed Page 18907 Start Printed Page 18908 Start Printed Page 18909 Start Printed Page 18910 Start Printed Page 18911 Start Printed Page 18912 Start Printed Page 18913 Start Printed Page 18914 Start Printed Page 18915 Start Printed Page 18916 Start Printed Page 18917 Start Printed Page 18918 End Supplemental InformationGordon H. Mansfield,
Deputy Secretary of Veterans Affairs.
Document Information
- Published:
- 04/11/2005
- Department:
- Veterans Affairs Department
- Entry Type:
- Notice
- Action:
- Notice.
- Document Number:
- 05-6754
- Pages:
- 18465-18918 (454 pages)
- PDF File:
- 05-6754.pdf