54440 Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices

DEPARTMENT OF DEFENSE

Office of the Secretary

Medical and Dental Services Fiscal

Year 1998

ACTION: Notice.

SUMMARY: Notice is hereby given that

the Deputy Chief Financial Officer in a

memorandum dated September 26, 1997

established the following

reimbursement rates for inpatient and

outpatient medical care to be provided

in FY 1998. These rates are effective

October 1, 1997.

Inpatient, Outpatient and Other Rates and Charges

I. Inpatient rates 1 2

Per inpatient day

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

A. Burn Center ............................................................................................................................. $2,618.00 $4,754.00 $5,079.00

B. Surgical Care Services (Cosmetic Surgery) ............................................................................ 955.00 1,733.00 1,852.00

C. All Other Inpatient Services (Based on Diagnosis Related Groups (DRG) 3)

1. FY98 Direct Care Inpatient Reimbursement Rates

Adjusted standard amount IMET Interagency Other (Full/

Third party)

Large Urban ................................................................................................................................. $2,199.00 $4,131.00 $4,372.00

Other Urban/Rural ........................................................................................................................ 2,194.00 4,215.00 4,499.00

Overseas ...................................................................................................................................... 2,450.00 5,614.00 5,960.00

2. Overview

The FY98 inpatient rates are based on the cost per DRG, which is the inpatient full reimbursement rate per hospital

discharge weighted to reflect the intensity of the principal diagnosis, secondary diagnoses, procedures, patient age,

etc. involved. The average cost per Relative Weighted Product (RWP) for large urban, other urban/rural, and overseas

facilities will be published annually as an inpatient adjusted standardized amount (ASA) (see paragraph I.C.1., above).

The ASA will be applied to the RWP for each inpatient case, determined from the DRG weights, outlier thresholds,

and payment rules published annually for hospital reimbursement rates under the Civilian Health and Medical Program

of the Uniformed Services (CHAMPUS) pursuant to 32 CFR 199.14(a)(1), including adjustments for length of stay (LOS)

outliers. The published ASAs will be adjusted for area wage differences and indirect medical education (IME) for

the discharging hospital. An example of how to apply DoD costs to a DRG standardized weight to arrive at DoD

costs is contained in paragraph I.C.3., below.

3. Example of Adjusted Standardized Amounts for Inpatient Stays

Figure 1 shows examples for a nonteaching hospital in a Large Urban Area.

a. The cost to be recovered is DoD’s cost for medical services provided in the nonteaching hospital located in

a large urban area. Billings will be at the third party rate.

b. DRG 020: Nervous System Infection Except Viral Meningitis. The RWP for an inlier case is the CHAMPUS

weight of 2.9769. (DRG statistics shown are from FY 1996).

c. The DoD adjusted standardized amount to be charged is $4,372 (i.e., the third party rate as shown in the table).

d. DoD cost to be recovered at a nonteaching hospital with area wage index of 1.0 is the RWP factor (2.9769

) in 3.b., above, multiplied by the amount ($4,372) in 3.c., above.

e. Cost to be recovered is $13,015.

FIGURE 1.—THIRD PARTY BILLING EXAMPLES

DRG

No. DRG description DRG weight Arithmeticmean LOS

Geometric

mean LOS

Short stay

threshold

Long stay

threshold

020 ... Nervous System Infection Except Viral Meningitis .................... 2.9769 11.2 7.8 1 30

Hospital Location Area wage

rate index

IME adjustment Group ASA Applied

ASA

Nonteaching Hospital ................................................................................ Large

Urban

1.0 1.0 $4,372.00 $4,372.00

Patient Length of stay Days above

threshold

Relative weighted product TPC

amount*** Inlier* Outlier** Total

#1 ............. 7 days ................................................................................. 0 2.9769 0.0000 2.9769 $13,015
Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices 54441

Patient Length of stay Days above

threshold

Relative weighted product TPC

amount*** Inlier* Outlier** Total

#2 ............. 21 days ............................................................................... 0 2.9769 0.0000 2.9769 13,015

#3 ............. 35 days ............................................................................... 5 2.9769 0.6297 3.6066 15,768

* DRG Weight

** Outlier calculation = 33 percent of per diem weight × number of outlier days = .33 (DRG Weight/Geometric Mean LOS) × (Patient LOS—Long Stay Threshold) = .33 (2.9769/7.8) × (35–30) = .33 (.38165) × 5 (take out to five decimal places) = .12594 × 5 (take out to five decimal places) = .6297 (take out to four decimal places)

***Applied ASA × Total RWP

II. Outpatient Rates 1 2 Per Visit

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

A. Medical Care

BAA .......... Internal Medicine .................................................................................................... $105.00 $195.00 $208.00

BAB .......... Allergy .................................................................................................................... 39.00 73.00 78.00

BAC ......... Cardiology .............................................................................................................. 81.00 150.00 160.00

BAE .......... Diabetic .................................................................................................................. 44.00 82.00 87.00

BAF .......... Endocrinology (Metabolism) ................................................................................... 85.00 158.00 168.00

BAG ......... Gastroenterology .................................................................................................... 110.00 203.00 216.00

BAH ......... Hematology ............................................................................................................ 145.00 269.00 287.00

BAI ........... Hypertension .......................................................................................................... 81.00 149.00 159.00

BAJ .......... Nephrology ............................................................................................................. 171.00 317.00 338.00

BAK .......... Neurology ............................................................................................................... 109.00 202.00 215.00

BAL .......... Outpatient Nutrition ................................................................................................ 34.00 63.00 67.00

BAM ......... Oncology ................................................................................................................ 114.00 211.00 225.00

BAN ......... Pulmonary Disease ................................................................................................ 141.00 260.00 278.00

BAO ......... Rheumatology ........................................................................................................ 84.00 156.00 166.00

BAP .......... Dermatology ........................................................................................................... 63.00 117.00 124.00

BAQ ......... Infectious Disease .................................................................................................. 141.00 260.00 278.00

BAR ......... Physical Medicine .................................................................................................. 78.00 145.00 155.00

BAS .......... Radiation Therapy .................................................................................................. 72.00 132.00 141.00

BAZ .......... Medical Care Not Elsewhere Classified (NEC) ..................................................... 84.00 156.00 166.00

B. Surgical Care

BBA .......... General Surgery ..................................................................................................... 119.00 220.00 235.00

BBB .......... Cardiovascular and Thoracic Surgery ................................................................... 110.00 203.00 216.00

BBC ......... Neurosurgery .......................................................................................................... 137.00 253.00 270.00

BBD ......... Ophthalmology ....................................................................................................... 84.00 155.00 166.00

BBE .......... Organ Transplant ................................................................................................... 191.00 353.00 376.00

BBF .......... Otolaryngology ....................................................................................................... 88.00 162.00 173.00

BBG ......... Plastic Surgery ....................................................................................................... 100.00 184.00 196.00

BBH ......... Proctology .............................................................................................................. 67.00 124.00 132.00

BBI ........... Urology ................................................................................................................... 101.00 187.00 199.00

BBJ .......... Pediatric Surgery .................................................................................................... 89.00 164.00 175.00

BBZ .......... Surgical Care NEC ................................................................................................. 65.00 120.00 127.00

C. Obstetrical and Gynecological (OB-GYN) Care

BCA ......... Family Planning ...................................................................................................... 45.00 83.00 89.00

BCB ......... Gynecology ............................................................................................................ 74.00 136.00 146.00

BCC ......... Obstetrics ............................................................................................................... 68.00 126.00 135.00

BCZ .......... OB-GYN Care NEC ............................................................................................... 112.00 207.00 221.00

D. Pediatric Care

BDA ......... Pediatric ................................................................................................................. 54.00 100.00 106.00

BDB ......... Adolescent .............................................................................................................. 55.00 101.00 108.00

BDC ......... Well Baby ............................................................................................................... 36.00 66.00 70.00

BDZ .......... Pediatric Care NEC ................................................................................................ 64.00 119.00 126.00

E. Orthopaedic Care

BEA .......... Orthopaedic ............................................................................................................ 83.00 153.00 164.00

BEB .......... Cast ........................................................................................................................ 45.00 82.00 88.00

BEC ......... Hand Surgery ......................................................................................................... 38.00 70.00 75.00
54442 Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

BEE .......... Orthotic Laboratory ................................................................................................ 59.00 110.00 117.00

BEF .......... Podiatry .................................................................................................................. 49.00 91.00 97.00

BEZ .......... Chiropractic ............................................................................................................ 21.00 38.00 40.00

F. Psychiatric and/or Mental Health Care

BFA .......... Psychiatry ............................................................................................................... 97.00 179.00 191.00

BFB .......... Psychology ............................................................................................................. 71.00 132.00 141.00

BFC .......... Child Guidance ....................................................................................................... 59.00 109.00 117.00

BFD .......... Mental Health ......................................................................................................... 80.00 147.00 157.00

BFE .......... Social Work ............................................................................................................ 80.00 149.00 159.00

BFF .......... Substance Abuse ................................................................................................... 62.00 115.00 123.00

G. Family Practice/Primary Medical Care

BGA ......... Family Practice ....................................................................................................... 67.00 124.00 132.00

BHA ......... Primary Care .......................................................................................................... 64.00 118.00 126.00

BHB ......... Medical Examination .............................................................................................. 59.00 109.00 117.00

BHC ......... Optometry ............................................................................................................... 42.00 77.00 82.00

BHD ......... Audiology ................................................................................................................ 30.00 55.00 58.00

BHE ......... Speech Pathology .................................................................................................. 81.00 149.00 159.00

BHF .......... Community Health .................................................................................................. 41.00 75.00 80.00

BHG ......... Occupational Health ............................................................................................... 59.00 108.00 115.00

BHH ......... TRICARE Outpatient .............................................................................................. 42.00 78.00 83.00

BHI ........... Immediate Care ...................................................................................................... 82.00 152.00 162.00

BHZ .......... Primary Care NEC ................................................................................................. 43.00 79.00 84.00

H. Emergency Medical Care

BIA ........... Emergency Medical ................................................................................................ 107.00 198.00 211.00

I. Flight Medical Care

BJA .......... Flight Medicine ....................................................................................................... 85.00 157.00 167.00

J. Underseas Medical Care

BKA .......... Underseas Medicine .............................................................................................. 32.00 58.00 62.00

K. Rehabilitative Services

BLA .......... Physical Therapy .................................................................................................... 29.00 54.00 57.00

BLB .......... Occupational Therapy ............................................................................................ 53.00 98.00 104.00

III. Other Rates and Charges 1 2 Per Visit

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

FBI ........... A. Immunization ..................................................................................................... $10.00 $19.00 $20.00

DGC ......... B. Hyperbaric Chamber 5 ....................................................................................... 180.00 333.00 355.00

C. Ambulatory Procedure Visit (APV).6 376.00 691.00 737.00

D. Family Member Rate (formerly Military Dependents Rate) .............................. 10.20 ........................ ........................

E. Reimbursement Rates For Drugs Requested By Outside Providers 7

The FY 1998 drug reimbursement rates for drugs are for prescriptions requested by outside providers and obtained

at a Military Treatment Facility. The rates are established based on the cost of the particular drugs provided. Final

rule of 32 CFR Part 220, estimated to be published October 1, 1997, will eliminate the high cost ancillary services’

dollar threshold and the associated term ‘‘high cost ancillary service.’’ In anticipation of that change, the phrase ‘‘high

cost ancillary service’’ has been replaced with the phrase ‘‘ancillary services requested by an outside provider.’’ The

list of drug reimbursement rates is too large to include here. These rates are available on request from OASD (Health

Affairs), LTC Michael Montgomery, 703–681–8910.

F. Reimbursement Rates for Ancillary Services Requested By Outside Providers 8

Final rule of 32 CFR Part 220, estimated to be published October 1, 1997, will eliminate the high cost ancillary

services’ dollar threshold and the associated term ‘‘high cost ancillary service.’’ In anticipation of that change, the
Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices 54443

phrase ‘‘high cost ancillary service’’ has been replaced with the phrase ‘‘ancillary services requested by an outside

provider.’’ The list of FY 1998 rates for ancillary services requested by outside providers and obtained at a Military

Treatment Facility is too large to include here. These rates are available on request from OASD (Health Affairs) LTC

Michael Montgomery, 703–681–8910.

G. Elective Cosmetic Surgery Procedures and Rates

Cosmetic surgery procedureInternational Classification Diseases (ICD–9)Current Procedural Terminology (CPT) 9 FY 1998 charge 10 Amount of

charge

Mammaplasty ................. 85.50, 85.32, 85.31 ....... 19325, 19324, 19318 .... Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Mastopexy ...................... 85.60 ............................. 19316 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Facial Rhytidectomy ....... 86.82, 86.22 .................. 15824 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Blepharoplasty ................ 08.70, 08.44 .................. 15820, 15821, 15822,

15823.

Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Mentoplasty (Augmentation/Reduction).76.68, 76.67 .................. 21208, 21209 ................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Abdominoplasty .............. 86.83 ............................. 15831 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Lipectomy suction per region.1186.83 ............................. 15876, 15877, 15878,

15879.

Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Rhinoplasty ..................... 21.87, 21.86 .................. 30400, 30410 ................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Scar Revisions beyond

CHAMPUS.

86.84 ............................. 1578l ........................... Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Mandibular or Maxillary

Repositioning.

76.41 ............................. 21194 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Minor Skin Lesions.12 86.30 ............................. 1578l ........................... Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Dermabrasion ................. 86.25 ............................. 15780 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Hair Restoration .............. 86.64 ............................. 15775 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Removing Tattoos .......... 86.25 ............................. 15780 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Chemical Peel ................ 86.24 ............................. 15790 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Arm/Thigh

Dermolipectomy.

86.83 ............................. 1583l ........................... Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

Brow Lift .......................... 86.3 ............................... 15839 ............................ Inpatient Surgical Care Per Diem or APV or applicable Outpatient Clinic Rate.

a b c

H. Dental Rate 13 Per Procedure

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

Dental Services ...................................................................................................... $35.00 $101.00 $106.00

ADA code and DoD established weight.

I. Ambulance Rate 14 Per Visit

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

FEA .......... Ambulance ............................................................................................................. $32.00 $60.00 $64.00

J. Laboratory and Radiology Services Requested by an Outside Provider 8 Per Procedure

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

Laboratory procedures requested by an outside provider CPT–4 Weight Multiplier.$9.00 $13.00 $14.00
54444 Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

Radiology procedures requested by an outside provider CPT–4 Weight Multiplier.23.00 35.00 37.00

K. AirEvac Rate 15 Per Visit

MEPRS

code 4 Clinical service

International

Military Education & Training (IMET)

Interagency

and other Federal agency

sponsored patients

Other (Full/

Third party)

AirEvac Services—Ambulatory .............................................................................. $113.00 $209.00 $223.00

AirEvac Services—Litter ........................................................................................ 323.00 598.00 638.00

Notes on Cosmetic Surgery Charges:

aPer diem charges for inpatient surgical care services are listed in Section I.B. (See notes 9 through 11, below, for further details

on reimbursable rates.) bCharges for ambulatory procedure visits (formerly same day surgery) are listed in Section III.C. (See notes 9 through 11, below,

for further details on reimbursable rates.) The ambulatory procedure visit (APV) rate is used if the elective cosmetic surgery is performed

in an ambulatory procedure unit (APU). cCharges for outpatient clinic visits are listed in Sections II.A–K. The outpatient clinic rate is not used for services provided

in an APU. The APV rate should be used in these cases.

Notes on Reimbursable Rates:

1Percentages can be applied when preparing bills for both inpatient and outpatient services. Pursuant to the provisions of 10

U.S.C. 1095, the inpatient Diagnosis Related Groups and inpatient per diem percentages are 96 percent hospital and 4 percent professional

charges. The outpatient per visit percentages are 88 percent outpatient services and 12 percent professional charges. 2 DoD civilian employees located in overseas areas shall be rendered a bill when services are performed. Payment is due 60

days from the date of the bill. 3The cost per Diagnosis Related Group (DRG) is based on the inpatient full reimbursement rate per hospital discharge, weighted

to reflect the intensity of the principal and secondary diagnoses, surgical procedures, and patient demographics involved. The adjusted

standardized amounts (ASA) per Relative Weighted Product (RWP) for use in the direct care system is comparable to procedures

used by the Health Care Financing Administration (HCFA) and the Civilian Health and Medical Program for the Uniformed Services

(CHAMPUS). These expenses include all direct care expenses associated with direct patient care. The average cost per RWP for large

urban, other urban/rural, and overseas will be published annually as an adjusted standardized amount (ASA) and will include the

cost of inpatient professional services. The DRG rates will apply to reimbursement from all sources, not just third party payers. 4The Medical Expense and Performance Reporting System (MEPRS) code is a three digit code which defines the summary account

and the subaccount within a functional category in the DoD medical system. MEPRS codes are used to ensure that consistent expense

and operating performance data is reported in the DoD military medical system. An example of the MEPRS hierarchical arrangement

follows:

MEPRS

code

Outpatient Care (Functional Category) .......................................................................................................................................................... B

Medical Care (Summary Account) ................................................................................................................................................................. BA

Internal Medicine (Subaccount) ..................................................................................................................................................................... BAA

5Hyperbaric services charges shall be based on hours of service in 15 minute increments. The rates listed in Section III.B. are

for 60 minutes or 1 hour of service. Providers shall calculate the charges based on the number of hours (and/or fractions of an

hour) of service. Fractions of an hour shall be rounded to the next 15 minute increment (e.g., 31 minutes shall be charged as 45

minutes). 6Ambulatory procedure visit is defined in DOD Instruction 6025.8, ‘‘Ambulatory Procedure Visit (APV),’’ dated September 23,

1996, as immediate (day of procedure) pre-procedure and immediate post-procedure care requiring an unusual degree of intensity

and provided in an ambulatory procedure unit (APU). Care is required in the facility for less than 24 hours. This rate is also used

for elective cosmetic surgery performed in an APU. 7Prescription services requested by outside providers (e.g., physicians or dentists) are relevant to the Third Party Collection Program.

Third party payers (such as insurance companies) shall be billed for prescription services when beneficiaries who have medical insurance

obtain medications from a Military Treatment Facility (MTF) that are prescribed by providers external to the MTF. Eligible beneficiaries

(family members or retirees with medical insurance) are not personally liable for this cost and shall not be billed by the MTF.

Medical Services Account (MSA) patients, who are not beneficiaries as defined in 10 U.S.C. 1074 and 1076, are charged at the

‘‘Other’’ rate if they are seen by an outside provider and only come to the MTF for prescription services. The standard cost of

medications ordered by an outside provider includes the cost of the drugs plus a dispensing fee per prescription. The prescription

cost is calculated by multiplying the number of units (e.g., tablets or capsules) by the unit cost and adding a $5.00 dispensing

fee per prescription. The final rule at 32 CFR Part 220, estimated to be published October 1, 1997, will eliminate the dollar threshold

for high cost ancillary services (by changing the threshold from $25 to $0) and the associated term ‘‘high cost ancillary service.’’

In anticipation of that change, the phrase ‘‘high cost ancillary service’’ has been replaced with the phrase ‘‘ancillary services requested

by an outside provider.’’ The elimination of the threshold also eliminates the bundling of costs whereby a patient is billed if the

total cost of ancillary services in a day (defined as 0001 hours to 2400 hours) exceeded $25.00. 8Charges for ancillary services requested by an outside provider (physicians, dentists, etc.) are relevant to the Third Party Collection

Program. Third party payers (such as insurance companies) shall be billed for ancillary services when beneficiaries who have medical
Federal Register / Vol. 62, No. 202 / Monday, October 20, 1997 / Notices 54445

insurance obtain services from the MTF that are prescribed by providers external to the MTF. Laboratory and Radiology procedure

costs are calculated using the Physicians’ Current Procedural Terminology (CPT)–4 Report weight multiplied by either the laboratory

or radiology multiplier (Section III.J). Eligible beneficiaries (family members or retirees with medical insurance) are not personally

liable for this cost and shall not be billed by the MTF. MSA patients, who are not beneficiaries as defined by 10 U.S.C. 1074

and 1076, are charged at the ‘‘Other’’ rate if they are seen by an outside provider and only come to the MTF for services. The

final rule at 32 CFR Part 220, estimated to be published October 1, 1997, will eliminate the dollar threshold for high cost ancillary

services (by changing the threshold from $25 to $0) and the associated term ‘‘high cost ancillary service.’’ In anticipation of that

change, the phrase ‘‘high cost ancillary service’’ has been replaced with the phrase ‘‘ancillary services requested by an outside provider.’’

The elimination of the threshold also eliminates the bundling of costs whereby a patient is billed if the total cost of ancillary services

in a day (defined as 0001 hours to 2400 hours) exceeded $25.00. 9The attending physician is to complete the CPT–4 code to indicate the appropriate procedure followed during cosmetic surgery.

The appropriate rate will be applied depending on the treatment modality of the patient: Ambulatory procedure visit, outpatient

clinic visit or inpatient surgical care services. 10Family members of active duty personnel, retirees and their family members, and survivors shall be charged elective cosmetic

surgery rates. Elective cosmetic surgery procedure information is contained in Section III.G. The patient shall be charged the rate

as specified in the FY 1998 reimbursable rates for an episode of care. The charges for elective cosmetic surgery are at the full

reimbursement rate (designated as the ‘‘Other’’ rate) for inpatient per diem surgical care services in Section I.B., ambulatory procedure

visits as contained in Section III.C, or the appropriate outpatient clinic rate in Sections II.A–K. The patient is responsible for the

cost of the implant(s) and the prescribed cosmetic surgery rate. (NOTE: The implants and procedures used for the augmentation

mammaplasty are in compliance with Federal Drug Administration guidelines.) 11Each regional lipectomy shall carry a separate charge. Regions include head and neck, abdomen, flanks, and hips. 12These procedures are inclusive in the minor skin lesions. However, CHAMPUS separates them as noted here. All charges shall

be for the entire treatment, regardless of the number of visits required. 13 Dental service rates are based on a dental rate multiplier times the American Dental Association (ADA) code and the DoD

established weight for that code. 14Ambulance charges shall be based on hours of service in 15 minute increments. The rates listed in Section III.I are for 60

minutes or 1 hour of service. Providers shall calculate the charges based on the number of hours (and/or fractions of an hour)

that the ambulance is logged out on a patient run. Fractions of an hour shall be rounded to the next 15 minute increment (e.g.,

31 minutes shall be charged as 45 minutes). 15Air in-flight medical care reimbursement charges are determined by the status of the patient (ambulatory or litter) and are

per patient. The charges are billed only by the Air Force Global Patient Movement Requirement Center (GPMRC).

Dated: October 14, 1997.

L.M. Bynum,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR No. 97–27647 Filed 10–17–97; 8:45 am]

BILLING CODE 5000–04–P

DEPARTMENT OF DEFENSE

Office of the Secretary

Meeting of the Task Force on Defense

Reform

AGENCY: Department of Defense, Task

Force on Defense Reform.

ACTION: Notice.

SUMMARY: The Task Force on Defense

Reform will meet in closed sessions on

November 4, 6, 13, 18, 20, and 25, 1997.

The Task Force on Defense Reform

was established to make

recommendations to the Secretary of

Defense and Deputy Secretary of

Defense on alternatives for

organizational reforms, reductions in

management overhead, and streamlined

business practices in the Department of

Defense (DoD), with emphasis on the

Office of the Secretary of Defense, the

Defense Agencies, the DoD field

activities, and the Military Departments.

In accordance with Section 10(d) of

the Federal Advisory Committee Act,

Pub. L. 92–463, as amended, 5 U.S.C.,

Appendix II, it has been determined that

matters affecting national security, as

covered by 5 U.S.C. 552b(c)(1)(1988),

will be presented throughout the

meetings, and that, accordingly, these

meetings will be closed to the public.

Dated: October 14, 1997.

L.M. Bynum,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR Doc. 97–27645 Filed 10–17–97; 8:45 am]

BILLING CODE 5000–04–M

DEPARTMENT OF DEFENSE

Department of the Air Force

HQ USAF Scientific Advisory Board

Meeting

The Aerial Targets, UAVs, and Ranges

Symposium in support of the HQ USAF

Scientific Advisory Board will meet in

Las Vegas, NV on November 12–13,

1997, from 8:00 a.m. to 5:00 p.m.

The purpose of the meeting is to

gather information and receive briefings

on Aerial Targets, UAVs, and Ranges.

The meeting will be closed to the

public in accordance with Section 552b

of Title 5, United States Code,

specifically subparagraphs (1) and (4)

thereof.

For further information, contact the

HQ USAF Scientific Advisory Board

Secretariat at (703) 697–8404.

Barbara A. Carmichael,

Alternate Air Force Federal Register Liaison

Officer.

[FR Doc. 97–27681 Filed 10–17–97; 8:45 am]

BILLING CODE 3910–01–U

DEPARTMENT OF ENERGY

Office of Fossil Energy

National Coal Council; Notice of Open

Meeting

Pursuant to the provisions of the

Federal Advisory Committee Act (Pub.

L. 92–463, 86 Stat. 770), notice is hereby

given of the following meeting:

Name: National Coal Council.

Date And Time: Friday, November 14,

1997, 8:30 am.

Place: Hyatt Regency, Westshore, 6200

Courtney Campbell Causeway, Tampa, FL.

Contact: Margie D. Biggerstaff, U.S.

Department of Energy, Office of Fossil Energy

(FE–5), Washington, D.C. 20585, Telephone:

202/586–3867.

Purpose of the Council: To provide advice,

information, and recommendations to the

Secretary of Energy on matters relating to

coal and coal industry issues.