[Federal Register Volume 86, Number 147 (Wednesday, August 4, 2021)]
[Notices]
[Pages 42015-42016]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-16627]


=======================================================================
-----------------------------------------------------------------------

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 
2022

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, 2021.

FOR FURTHER INFORMATION CONTACT: Ms. Debra Vatthauer, Office of 
Community Care, Revenue Operations, Payer Relations and Services, Rates 
and Charges (13RO1), 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 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.
    The following table depicts the Cost-Based and Inter-Agency rates 
that are effective October 1, 2021 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 July 28, 2020, 
at 85 FR 45471.

------------------------------------------------------------------------
                                            Cost-based     Inter-agency
                                               rates           rates
------------------------------------------------------------------------
A. Hospital Care per inpatient day
    General Medicine:
        All Inclusive Rate..............          $5,466          $5,318
        Physician.......................             654  ..............
        Ancillary.......................           1,424  ..............
        Nursing Room and Board..........           3,388  ..............
    Neurology:
        All Inclusive Rate..............           5,127           4,981
        Physician.......................             751  ..............
        Ancillary.......................           1,354  ..............
        Nursing Room and Board..........           3,022  ..............
    Rehabilitation Medicine:
        All Inclusive Rate..............           3,963           3,846
        Physician.......................             450  ..............
        Ancillary.......................           1,211  ..............
        Nursing Room and Board..........           2,302  ..............
    Blind Rehabilitation:
        All Inclusive Rate..............           2,933           2,843
        Physician.......................             236  ..............
        Ancillary.......................           1,457  ..............
        Nursing Room and Board..........           1,240  ..............
    Spinal Cord Injury:
        All Inclusive Rate..............           3,548           3,443
        Physician.......................             440  ..............
        Ancillary.......................             893  ..............
        Nursing Room and Board..........           2,215  ..............
    Surgery:
        All Inclusive Rate..............           9,756           9,490
        Physician.......................           1,075  ..............
        Ancillary.......................           2,959  ..............
        Nursing Room and Board..........           5,722  ..............
    General Psychiatry:
        All Inclusive Rate..............           2,875           2,788
        Physician.......................             271  ..............
        Ancillary.......................             453  ..............
        Nursing Room and Board..........           2,151  ..............
    Substance Abuse (Alcohol and Drug
     Treatment):
        All Inclusive Rate..............           2,744           2,663

[[Page 42016]]

 
        Physician.......................             262  ..............
        Ancillary.......................             635  ..............
        Nursing Room and Board..........           1,847  ..............
    Psychosocial Residential
     Rehabilitation Program:
        All Inclusive Rate..............             358             348
        Physician.......................              23  ..............
        Ancillary.......................              38  ..............
        Nursing Room and Board..........             297  ..............
    Intermediate Medicine:
        All Inclusive Rate..............           3,269           3,179
        Physician.......................             161  ..............
        Ancillary.......................             480  ..............
        Nursing Room and Board..........           2,628  ..............
    Poly-trauma Inpatient:
        All Inclusive Rate..............           3,936           3,805
        Physician.......................             447  ..............
        Ancillary.......................           1,202  ..............
        Nursing Room and Board..........           2,287  ..............
B. Nursing Home Care, Per Day
    All Inclusive Rate                             1,750           1,698
    Physician...........................              54  ..............
    Ancillary...........................             237  ..............
    Nursing Room and Board..............           1,459  ..............
C. Outpatient Medical Treatments
    Outpatient Visit (to include                     506             493
     Ineligible Emergency Dental Care)..
    Outpatient Physical Medicine &                   347             336
     Rehabilitation Service Visit.......
    Outpatient Poly-trauma/Traumatic                 678             660
     Brain Injury.......................
------------------------------------------------------------------------

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, approved this 
document on July 30, 2021, 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. 2021-16627 Filed 8-3-21; 8:45 am]
BILLING CODE 8320-01-P