Document headings vary by document type but may contain
                    the following: the agency or agencies that issued and signed a document
the number of the CFR title and the number of each part
                      the document amends, proposes to amend, or is directly
                      related to
the agency docket number / agency internal file number
the RIN which identifies each regulatory action listed in
                      the Unified Agenda of Federal Regulatory and Deregulatory
                      Actions See the
                    Document Drafting Handbook
                    for more details.
 Department of Veterans Affairs
 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 Department of Veterans Affairs (VA) furnished in certain circumstances.
 DATES: The rates set forth herein are effective August 28, 2018 and until further notice.
 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, (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 38 CFR 17.102(h). Two sets of rates are obtained by applying this methodology, Cost-Based and Inter-Agency. In accordance with 38 CFR 17.102(a), (b), (d), and (g) respectively, Cost-Based rates apply to medical care and services that are provided by VA: 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. In accordance with 38 CFR 17.102(c) and (f), Inter-Agency rates apply to medical care and services that are provided by VA to beneficiaries of the Department of Defense or other Federal agencies, when the care or services provided is not covered by an applicable sharing agreement, unless otherwise stated. The calculations for the Cost-Based and Inter-Agency rates are the same with two exceptions. Inter-Agency rates are all-inclusive, are not broken down into three components (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 effective upon publication of this notice and will remain in effect until the next 
                    **Federal Register**
                     notice is published. These rates supersede those established by the 
                    **Federal Register**
                     notice published on August, 29 2017, at 82 FR 41093. Cost-Based
                             rates
Inter-Agency
                             ratesA. Hospital Care per inpatient day:General Medicine:All Inclusive Rate
$4,025
$3,882Physician
482Ancillary
1,049Nursing Room and Board
2,494Neurology:All Inclusive Rate
3,805
3,664Physician
557Ancillary
1,005Nursing Room and Board
2,243Rehabilitation Medicine:All Inclusive Rate
2,749
2,641Physician
312Ancillary
840Nursing Room and Board
1,597( print page 43959)Blind Rehabilitation:All Inclusive Rate
1,843
1,770Physician
148Ancillary
916Nursing Room and Board
779Spinal Cord Injury:All Inclusive Rate
2,431
2,338Physician
301Ancillary
612Nursing Room and Board
1,518Surgery:All Inclusive Rate
6,832
6,590Physician
753Ancillary
2,072Nursing Room and Board
4,007General Psychiatry:All Inclusive Rate
1,993
1,913Physician
188Ancillary
314Nursing Room and Board
1,491Substance Abuse (Alcohol and Drug Treatment):All Inclusive Rate
1,963
1,884Physician
187Ancillary
454Nursing Room and Board
1,322Psychosocial Residential Rehabilitation Program:All Inclusive Rate
768
740Physician
48Ancillary
81Nursing Room and Board
639Intermediate Medicine:All Inclusive Rate
2,483
2,388Physician
122Ancillary
364Nursing Room and Board
1,997Poly-trauma Inpatient:All Inclusive Rate
3,113
2,981Physician
354Ancillary
951Nursing Room and Board
1,808B. Nursing Home Care, Per Day:All Inclusive Rate
1,268
1,218Physician
39Ancillary
172Nursing Room and Board
1057C. Outpatient Medical Treatments:Outpatient Visit (to include Ineligible Emergency Dental Care)
362
350Outpatient Physical Medicine & Rehabilitation Service Visit
223
213Outpatient Poly-trauma/Traumatic Brain Injury
602
580**Note:**
                         Outpatient Prescriptions will be billed at Drug Cost plus Administrative Fee.
 Signing Authority The Secretary of Veterans Affairs 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. Robert L. Wilkie, Secretary, Department of Veterans Affairs, approved this document on August 22, 2018, for publication. Dated: August 22, 2018. Jeffrey M. Martin, Impact Analyst, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs.


[FR Doc. 2018-18555 Filed 8-27-18; 8:45 am] BILLING CODE 8320-01-P