N.Y. Comp. Codes R. & Regs. tit. 10 § 444.20

Current through Register Vol. 46, No. 45, November 2, 2024

Section 444.20 - Ancillary services expenses description

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(a) 7010 LABOR AND DELIVERY SERVICES

(1) Function. Labor and Delivery services are provided by specially trained personnel to patients in Labor and Delivery, including prenatal care in labor, assistance in delivery, postnatal care in recovery, and minor gynecological procedures, if performed in the Delivery suite. Additional activities include, but are not limited to, the following:

Comforting patients in the labor and delivery and recovery rooms; maintaining aseptic techniques; preparing for deliveries and surgery; cleaning up after deliveries to the extent of preparation for pickup and disposal of used linen, gloves, instruments, utensils, equipment and waste; arranging sterile setup for deliveries and surgery; preparing patient for transportation to delivery room and recovery room; enforcing of safety rules and standards; monitoring of patients while in recovery.

(2) Description. This cost center contains the direct expenses incurred in providing care to maternity patients in labor, delivery, and recovery rooms. Included as direct expenses are: salaries and wages, employee benefits, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: number of procedures. Report multiple births as one procedure. Include Caesarean sections only when they are performed in delivery room. Caesarean sections performed in the Surgical suite shall be included in the operating room statistics. Stillbirths are counted as procedures. Infants born outside the hospital building are not to be classified as a procedure unless care was rendered in the Labor and Delivery Services. Whenever obstetrical and gynecological procedures such as abortions, D & C's, etc. are performed in Labor and Delivery, each procedure performed is counted as one.

(4) Data source. The number of procedures shall be an actual count obtained from medical records, or as maintained by Labor and Delivery.

(b)Surgical Services Group.

(1)

7040 SURGERY SERVICES..........................................................................................................

7041 General Surgery..........................................................................................................

7042 Open Heart Surgery..........................................................................................................

7043 Neurosurgery..........................................................................................................

7044 Orthopedic Surgery..........................................................................................................

7045 Kidney Transplant..........................................................................................................

7046 Other Organ Transplants..........................................................................................................

7049 Other Operating Room Services..........................................................................................................

(i) Function. Surgical Services are provided to inpatients, and outpatients if the hospital uses a common operating room for both inpatients and outpatients, by physicians and specially trained nursing personnel who assist physicians in the performance of surgical and related procedures during and immediately following surgery. Additional activities include, but are not limited to, the following:

Comforting patients in the operating room; maintaining aseptic techniques; scheduling operations in conjunction with surgeons; assisting surgeon during operations; preparing for operations; cleaning up after operations to the extent of preparation for pickup and disposal of used linen, gloves, instruments, utensils, equipment and waste; assisting in preparing patients for surgery; inspecting, testing and maintaining special equipment related to this function; preparing patient for transportation to recovery room; counting of sponges, needles and instruments used during operation; enforcing of safety rules and standards.

(ii) Description. These cost centers contain the direct expenses incurred in providing surgical services to patients. When a common operating room is used for both inpatients and outpatients, the direct costs for both are to remain in this cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of surgery minutes. Surgery minutes is the difference between starting time and ending time, defined as follows:

Starting time is the beginning of anesthesia administered in the room in which the procedure is to be performed (or surgery if anesthesia is not administered or if anesthesia is not administered in the operating room).Ending timeis the end of surgery.

(iv) Data source. The number of surgery minutes shall be an actual count obtained from the operating room log.

(2) 7060 RECOVERY SERVICES

(i) Function. Recovery Services are provided by specially trained personnel immediately following surgery, including monitoring of patients while recovering from anesthesia. Additional activities include, but are not limited to, the following:

Comforting patients in the recovery room, maintaining aseptic techniques, monitoring of vital life signs, operating of specialized equipment related to this function, administering specified medication, observing patient's condition until all effects of the anesthesia have passed, preparing patient for transportation to acute care or intensive care units.

(ii) Description. This cost center contains the direct expenses incurred in monitoring of patients while recovering from anesthesia. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of recovery room minutes. Recovery room minutes is the difference between time of admission to recovery room and time of discharge from the unit.

(iv) Data source. The number of recovery room minutes shall be an actual count maintained by the recovery room.

(3) 7080 ANESTHESIOLOGY

(i) Function. Anesthesia services are rendered in the hospital by, or under the direction of, either a physician trained in anesthesia or the operating surgeon. Additional activities include, but are not limited to, the following:

Recording kind and amount of anesthetic administered; conducting physical examination of patients; observing patient's condition until all effects of the anesthesia have passed; obtaining laboratory findings before anesthetic is administered; administering treatment to patients having symptoms of post-anesthetic complication; accompanying patient to recovery room or intensive care unit; prescribing pre- and post-anesthesia medication; establishing and carrying out safeguards for administration of anesthetics.

(ii) Description. This cost center contains the direct expenses incurred in administering anesthetics under the direction of a physician. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of anesthesia minutes. Anesthesia time begins when the anesthesiologist begins to prepare the patient for the induction of anesthesia in the operating room or in an equivalent area, and ends when the anesthesiologist is no longer in personal attendance, that is, when the patient may be placed under post-operative supervision.

(iv) Data source. The number of anesthesia minutes shall be an actual count maintained by the Anesthesiology cost center.

(c)Medical Supplies and Equipment Group.

(1) 7110 MEDICAL SUPPLIES SOLD

(i) Description. The Medical Supplies Sold cost center is used for the accumulation of the invoice cost of all medical and surgical supplies sold directly to patients. The invoice/inventory cost of nonchargeable supplies and equipment issued by the Central Services and Supplies cost center (Account 8460) to other cost centers shall be reported in the using cost centers. If medical and surgical supplies are sold in other hospital cost centers, the cost of those items must be reported in to this cost center. The overhead cost of preparing and issuing medical and surgical supplies and equipment sold directly to patients must be reported in the Central Services and Supplies cost center (account 8460). The applicable portion of such overhead will be allocated to this cost center during the cost allocation process. The cost of reusable patient chargeable supplies must be reported in the Central Services and Supplies cost center. Do not report in this cost center the cost of durable medical equipment sold, leased or rented. Such costs are to be reported in accounts 7130 and 7140, Durable Medical Equipment-Sold, and Durable Medical Equipment-Leased/Rented, respectively.

(ii) Standard unit of measure: none required; not applicable.

(iii) Effective date. Relative to the separation of Durable Medical Equipment (accounts 7130 and 7140) from this cost center, the effective date is cost reporting periods beginning in 1982 and thereafter.

(2) 7130 DURABLE MEDICAL EQUIPMENT-SOLD ..........................................................................................................

(i) Description. The Durable Medical Equipment-Sold cost center is used to report the invoice/inventory costs of all durable medical equipment sold directly to patients. Durable Medical Equipment includes but is not limited to: hospital beds, wheelchairs, trapeze bars, oxygen tents, intermittent positive breathing machines, etc. Include in the appropriate Home Program Dialysis cost center the cost of dialysis and supportive equipment sold. The overhead cost of preparing and issuing durable medical equipment sold directly to patients and others must be reported in the Central Services and Supplies cost center (account 8460).

(ii) Standard unit of measure; none required; not applicable.

(iii) Effective date. Reporting periods beginning in 1982 and thereafter.

(3) 7140 DURABLE MEDICAL EQUIPMENT-LEASED/RENTED ..........................................................................................................

(i) Description. The Durable Medical Equipment-Leased/Rented cost center is used to report depreciation expenses related to the durable medical equipment leased or rented directly to patients and others. Durable medical equipment includes but is not limited to: hospital beds, wheelchairs, trapeze bars, crutches, canes, oxygen tents, intermittent positive breathing machines, exercycles, heat lamps, flotation mattresses, bed baths, etc. Include home program dialysis equipment and support in the appropriate Home Program Dialysis cost center. The overhead cost of preparing and issuing durable medical equipment leased and rented to patients and others must be reported in the Central Services and Supplies cost center (account 8460).

(ii) Standard Unit of Measure; none required; not applicable.

(iii) Effective date. Reporting periods beginning in 1982 and thereafter.

(d) 7150 DRUGS SOLD

(1) Description. The Drugs Sold cost center is used for the accumulation of the invoice/inventory cost of all pharmaceuticals, intravenous solutions and blood derivatives sold directly to patients. The invoice/inventory cost of non-chargeable drugs (pharmaceuticals, blood derivatives and I.V. solutions) issued by the Pharmacy (account 8470) to other cost centers shall be reported in the using cost centers. If such items are sold in other cost centers, the cost of those items must be transferred to this cost center. The overhead cost of preparing and issuing drugs sold directly to patients must be accumulated in the Pharmacy cost center (account 8470). The applicable portion of such overhead will be allocated to this cost center during the cost allocation process.

(2) Standard Unit of Measure: none required; not applicable.

(e)Laboratory Services Group.

(1)

7210 LABORATORY SERVICES-CLINICAL..........................................................................................................

7211 Chemistry..........................................................................................................

7212 Hematology..........................................................................................................

7213 Immunology (Serology)..........................................................................................................

7214 Microbiology (Bacteriology)..........................................................................................................

7215 Procurement and Dispatch..........................................................................................................

7216 Urine and Feces..........................................................................................................

7219 Other Clinical Laboratories..........................................................................................................

(i) Function. These cost centers perform diagnostic and routine clinical laboratory tests necessary for the diagnosis and treatment of hospital patients. Additional activities include, but are not limited to, the following:

Transporting specimens from nursing floors and operating rooms; drawing of blood samples; caring for laboratory animals and equipment; maintaining quality control.

(ii) Description. These cost centers contain the direct expenses incurred in the performance of laboratory tests necessary for diagnosis and treatment. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording Workload Measurement Units, workload units related to quality control standards, calibration standards and specimen collection, duplicates and repeats for which a patient is not charged are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.

(iv) Data source. The number of workload measurement units shall be an actual count maintained by the laboratory.

(2) 7230 LABORATORY SERVICES-PATHOLOGICAL ..........................................................................................................

7231 Cytology..........................................................................................................

7232 Histology..........................................................................................................

7233 Autopsy..........................................................................................................

7239 Other Pathological Laboratories..........................................................................................................

(i) Function. These cost centers perform diagnostic and routine laboratory tests on tissues and cultures necessary for the diagnosis and treatment of hospital patients. Additional activities include, but are not limited to, the following:

Mortuary operation, autopsy; transportation of specimens from nursing floors and operating rooms; care of laboratory animals and equipment; maintenance of quality control standards; preparation of samples for testing.

(ii) Description. These cost centers contain the direct expenses incurred in the performance of diagnostic and routine tests on tissues and cultures. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording Workload Measurement Units, workload units related to quality control studies, calibration standards and specimen collection, and repeats for which a patient is not charged, are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.

(iv) Data source. The number of workload measurement units shall be an actual count maintained by the laboratory.

(3) 7250 WHOLE BLOOD AND PACKED RED CELLS

(i) Function. This cost center procures and collects whole blood and packed red cells. Also included in the recruitment of donors.

(ii) Description. This cost center contains the direct expense incurred in procuring whole blood and packed red cells, drawing blood and recruiting and paying donors. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses. Do not include in this cost center the expenses incurred in performing tests on blood (i.e., typing, crossmatching, etc.). These expenses must be reported in Laboratory Services-Clinical (account 7210). The cost of blood derivatives is to be reported in account 7150, Drugs Sold (if the patient is charged), or the using cost center (if the patient is not charged).

The cost of blood (amount paid or fair market value) is reported in this cost center, or an inventory account if applicable, rather than netted against revenue or cleared through an agency account. When blood is purchased, cost is the amount paid. The service fee charged by the outside blood sources is not reported here but reported in Blood Processing and Storing (account 8480). When blood is donated, cost is its fair market value at the date of donation and an offsetting amount is reported in Donated Blood (account 5770).

If replacement blood is received by the hospital blood bank, the original amount charged the patient is reported in this cost center and removed from the patient's account (Accounts and Notes Receivable, account 1030).

(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition).

(iv) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.

(4) 7260 BLOOD PROCESSING AND STORING

(i) Function. This cost center processes, preserves, stores, and issues whole blood and packed red cells after it has been procured. Additional activities include, but are not limited to, the following:

Plasma fractionation; freezing and thawing blood; maintaining inventory control.

(ii) Description. This cost center contains the direct expenses incurred in processing, storing, and issuing whole blood and packed red cells after it has been procured. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses. Include in this cost center the cost of spoiled or defective blood, and the service fee charged by outside blood sources, whether or not the blood is replaced. Do not include in this cost center the expenses incurred in performing tests on blood (i.e., typing, crossmatching, etc.). These expenses must be reported in Laboratory Services-Clinical (account 7210). The cost of blood and packed red cells must be reported in the Whole Blood and Packed Red Cells cost center (account 7250). The cost of blood derivatives must be in the Drugs Sold cost center (account 7250) if the patient is charged, or the using cost center if the patient is not charged.

(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition).

(iv) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.

(f) 7290 ELECTROCARDIOGRAPHY

(1) Function. This cost center operates specialized equipment to record graphically electromotive variations in actions of the heart muscle; record graphically the direction and magnitude of the electrical forces of the heart's action; and/or record graphically the sounds of the heart for diagnostic purposes. Additional activities include, but are not limited to, the following:

Wheeling portable equipment to patients' bedside; explaining test procedures to patient; operating specialized equipment; inspecting, testing and maintaining special equipment; attaching and removing electrodes from patient.

(2) Description. This cost center contains the direct expenses incurred in performing electrocardiographic examinations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel.

(4) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.

(g) 7310 CARDIAC CATHETERIZATION LABORATORY

(1) Function. The Cardiac Catheterization Laboratory provides special diagnostic procedures such as catheterization required for care of patients with cardiac conditions.

(2) Description. This cost center shall contain the direct expenses incurred in providing cardiac catheterization diagnostic examinations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(3) Standard Unit of Measure: number of procedures. Count each cardiac catheterization procedure for which a charge is made as one procedure.

(4) Data source. The number of procedures shall be the actual count maintained by the Cardiac Catheterization Laboratory.

(h) Radiology Services Group.

(1) 7320 RADIOLOGY-DIAGNOSTIC ..........................................................................................................

7321 Angiocardiography..........................................................................................................

7322 Ultrasonography..........................................................................................................

7339 Radiology-Diagnostic-Other..........................................................................................................

(i) Function. This cost center provides diagnostic radiology services as required for the examination and care of patients under the direction of a qualified radiologist. Diagnostic radiology services include the taking, processing, examining and interpreting of radiography, ultrasonograms, and fluorographs. Additional activities include, but are not limited to, the following:

Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.

(ii) Description. This cost center contains the direct expenses incurred in providing diagnostic radiology services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: relative value units. Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and "BR" (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. (Count "Total Unit Value", not "PC Unit Value".)

(iv) Data source. The number of relative value units shall be the actual count maintained by the Radiology-Diagnostic cost center.

(2) 7340 CT SCANNER

(i) Function. The CT (computed tomographic) Scanner function provides computed tomographic scans of the head and other parts of the body.

(ii) Description. This cost center shall contain the direct expenses incurred in providing CT scans. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of procedures. Count each computed tomographic scanner procedure as one procedure. Count only those procedures which are charged for. A patient procedure is defined as the initial scan and any additional scans of the same anatomical area during a single visit.

(iv) Data source. The number of procedures shall be the actual count maintained by the CT Scanner cost center.

(3) 7360 RADIOLOGY-THERAPEUTIC

(i) Function. This cost center provides therapeutic radiology services as required for the care and treatment of patients under the direction of a qualified radiologist. Therapeutic radiology services include therapy by radium and radioactive substances. Additional activities include, but are not limited to, the following:

Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.

(ii) Description. This cost center contains the direct expenses incurred in providing therapeutic radiology services. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: relative value units. Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and "BR" (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimates by qualified personnel. (Count "Total Unit Value", not "PC Unit Value".)

(iv) Data source. The number of relative value units shall be the actual count maintained by the Radiology-Therapeutic cost center.

(4) 7380 NUCLEAR MEDICINE ..........................................................................................................

7381 Nuclear Medicine-Diagnostic..........................................................................................................

7382 Nuclear Medicine-Therapeutic..........................................................................................................

(i) Function. This cost center provides diagnosis and treatment by injectable or ingestible radioactive isotopes as required for the care and treatment of patients under the direction of a qualified physician. Additional activities include, but are not limited to, the following: Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.

(ii) Description. This cost center contains the direct expenses incurred in providing nuclear medicine services to patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iv) Data source. The number of relative value units shall be the actual count maintained by the Nuclear Medicine cost center.

(i) 7420 RESPIRATORY THERAPY

(1) Function. Respiratory therapy is the administration of oxygen and certain potent drugs through inhalation of positive pressure and other forms of rehabilitative therapy as prescribed by physicians. This function is performed by specially trained personnel who initiate, monitor and evaluate patient performance, cooperation and ability during testing procedures. Additional activities include, but are not limited to, the following:

Assisting physician in performance of emergency care; reviving and maintaining patients' vital life signs; maintaining open airways, breathing, and blood circulation; maintaining aseptic conditions; transporting equipment to patients' bedsides; observing and instructing patients during therapy; visiting all assigned patients to ensure that physicians' orders are being carried out; inspecting and testing equipment; enforcing safety rules; and calculating test results.

(2) Description. This cost center contains the direct expenses incurred in the administration of oxygen and other forms of therapy through inhalation. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. Oxygen charges would be reported as one per day regardless of service time. All-inclusive rate hospitals should count treatments as if a charge were to be made.

(4) Data source. The number of treatments shall be the actual count maintained by the Respiratory Therapy cost center.

(j) 7440 PULMONARY FUNCTION TESTING

(1) Function. This cost center tests patients through measurement of inhaled and exhaled gases and analysis of blood, and evaluation of the patient's ability to exchange oxygen and other gases. This function is performed by specially trained personnel who initiate, monitor and evaluate patient performance, cooperation and ability during testing procedures.

(2) Description. This cost center contains the direct expenses incurred in the performance of patient and laboratory testing necessary for diagnosis and treatment of pulmonary disorders. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording workload measurement units, workload units related to quality control standards, calibration standards, and specimen collection, duplicates and repeats for which a patient is not charged are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel.

(4) Data source. The number of workload measurement units shall be an actual count maintained by the Pulmonary Function Testing cost center.

(k) 7460 NEUROLOGY-DIAGNOSTIC ..........................................................................................................

7461 Electroencephalography..........................................................................................................

7462 Electromyography..........................................................................................................

(1) Function. This cost center provides diagnostic neurology services such as electroencephalography and electromyography. Specialized equipment is used to record electromotive variations in brain waves and to record electrical potential variation for diagnosis of muscular and nervous disorders. Additional activities include, but are not limited to, the following:

Wheeling portable equipment to patient's bedside; explaining test procedures to patient; operating specialized equipment; inspecting, testing and maintaining special equipment; attaching and removing electrodes from patients.

(2) Description. This cost center contains the direct expenses incurred in providing diagnostic neurology services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: relative value units. Diagnostic Neurology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and "BR" (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel.

(4) Data source. The number of relative value units shall be the actual count maintained by the Neurology-Diagnostic cost center.

(l) Therapy Services Group.

(1) 7510 PHYSICAL THERAPY

(i) Function. The Physical Therapy cost center provides patient evaluation and therapeutic activities, patient education and home visits. The cost center provides patient evaluations by performing and interpreting tests and measurements of cardiovascular, neuromuscular and musculoskeletel functions and establishes treatment programs. Treatment is administered through the use of therapeutic agents which employ the physical, chemical and other properties of air, water, electricity, sound and light. Specific evaluative and therapeutic activities provided by this cost center include, but are not limited to, the following:

Application of manual and electrical muscle and range of motion measurement; evaluation and fitting of prosthetic, orthotic and other assistive devices; functional testing and training; perceptual and sensory evaluations; planning and executing therapeutic exercise programs for increasing strength, endurance, coordination and range of motion; gait analysis and training; instruction and counseling patients and families.

(ii) Description. This cost center contains the direct expenses incurred in maintaining a physical therapy program, including home care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.

(iii) Standard Unit of Measure: number of relative value units and patient visits. The standard unit of measure will be the relative value units developed by the American Physical Therapy Association (see Part 447 of this Article). The number of relative value units counted per visit indicates the extent to which the cost center resources were used during a patient and resident visit. In addition to relative value units, the number of physical therapy patient visits must be reported. A patient visit is one appearance of a patient regardless of the number of evaluation, therapeutic and patient education activities performed during that appearance. Also included as patient visits are the home visits made by physical therapists. See account 6910 for a definition of home visits.

(iv) Data source. The number of relative value units shall be the actual count maintained by the Physical Therapy cost center.

(2) 7530 OCCUPATIONAL THERAPY

(i) Function. Occupational Therapy is the application of purposeful, goal-oriented activity in the evaluation, diagnosis and/or treatment of persons whose function is impaired by physical illness or injury, emotional disorder, congenital or developmental disability, or the aging process, in order to achieve optimum functioning, to prevent disability and to maintain health. Specific occupational therapy services include, but are not limited to, education and training in activities of daily living (ADL); the design, fabrication and application of orthoses (splints); sensorimotor activities; the use of specifically designed crafts; guidance in the selection and use of adaptive equipment; therapeutic activities to enhance functional performance; prevocational evaluation and training; and consultation concerning the adaptation of physical environments for the handicapped. These services are provided to individuals or groups, to both inpatients and outpatients and to home-bound patients.

(ii) Description. This cost center contains the direct expenses incurred in maintaining an occupational therapy program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of treatments (1980). Count each procedure as one treatment. In group sessions, the number of treatments would be equal to the number of patients in the group. Count only those procedures which are charged for.

(iv) Standard Unit of Measure: number of relative value units (1981). The standard unit of measure will be the relative value units developed by the American Occupational Therapy Association and is used at the association's request (see Part 447 of this Article). Relative value units for unlisted procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel.

(v) Data source. The number of treatments shall be obtained from an actual count maintained by the Occupational Therapy cost center.

(vi) Effective date. Relative to the Standard Unit of Measure for this cost center, the relative value units developed by the American Occupational Therapy Association will be effective July 1, 1981. For 1980 reporting purposes, report the "Number of Treatments" in accordance with the above definition.

(3) 7550 SPEECH-LANGUAGE PATHOLOGY

(i) Function. This cost center provides and coordinates services to persons with impaired functional communication skills. This includes the evaluation and management of any existing disorders of the communicative process centering entirely or in part on the reception and production of speech and lang age related to organic and/or nonorganic factors. Professional services provided by this cost center are group-ed into a minimum of three major areas: Diagnostic Assessment and Evaluation-including clinical appraisal of speech, voice and language competencies, through standardized and other tests, to determine need for and types of rehabilitation required; Rehabilitative Treatment-including planning and conducting treatment programs, on an individual or group basis, to develop, restore or improve communicative efficiency of persons disabled in the processes of speech, voice and/or language; and continuing Evaluation/Periodic Reevaluation-including both standardized and informal procedures to monitor progress and verify current status. Such activities may be coordinated with medical evaluation and treatment of hospitalized patients. Additional activities include, but are not limited to, the following: preparation of written diagnostic, evaluative and special reports; provision of extensive counseling and guidance to communicatively handicapped individuals and their families; and maintaining specialized equipment utilized in evaluation and treatment, such as auditory training instruments and speech-production prostheses.

(ii) Description. This cost center contains the direct expenses incurred in maintaining a Speech-Language Pathology cost center. Any expenses related to the sale of speech prostheses or other communication aids must not be included here, but accounted in the Medical Supplies Sold cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Units of Measure: number of sessions. Count each evaluation and each treatment session for which there is a charge as one session. For group activities, count as one session each patient participating in the session. Also included are sessions with home-bound patients.

(iv) Data source. The number of sessions shall be obtained from an actual count maintained by the Speech-Language Pathology cost center.

(4) 7570 RECREATIONAL THERAPY

(i) Function. Recreational Therapy services include the employment of sports, dramatics, arts and other recreational programs to stimulate the patients' recovery rate. Additional activities include, but are not limited to, the following:

Conducting and organizing instrumental and vocal musical activities and directing activities of volunteers in respect to these functions.

(ii) Description. This cost center contains the direct expenses incurred in maintaining a program of recreational therapy. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. For group activities, count as one treatment each patient in group.

(iv) Data source. The number of treatments shall be obtained from an actual count maintained by the Recreational Therapy cost center.

(5) 7580 AUDIOLOGY

(i) Function. This cost center provides and coordinates services to persons with impaired peripheral and/or central auditory function. This includes the detection and management of any existing communication handicaps centering in whole or in part on the hearing function. Some of the activities of this cost center are: audiologic assessment (including basic audiometric testing and screening, examination for site of lesion, nonorganic hearing loss and various parameters of auditory processing abilities essential for communication function); hearing aid evaluation, selection, orientation, adjustment and other technical related services; and audiologic habilitation and rehabilitation including the development, remediation or conservation of receptive and expressing language abilities. Such activities are coordinated with medical evaluation and treatment of hospital patients. Additional activities include, but are not limited to, the following:

Demonstrating and evaluating amplification devices and alerting systems; evaluating excessively noisy environments, writing special reports; providing extended counseling and guidance; inspecting, testing and maintaining special equipment.

(ii) Description. This cost center contains the direct expenses incurred in maintaining an Audiology cost center. The expense related to the sale of hearing aids must not be included here but accounted in the Medical Supplies Sold cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of procedures. Count each procedure for which a charge is made as one procedure. Based on the recommendations of the American Speech and Hearing Association, these procedures should include audiometric screening and identification; basic audiologic testing (including pure tone and speech threshold tests, speech disrimination tests and basic impedence tests); audiologic evaluation for site of lesion (including Bekesy audiometry, tone decay tests, loudness balance tests, special impedence tests, SISI test, distorted speech tests, competing speech tests and other measures of peripheral and central auditory structures); audiologic evaluation for nonorganicity; pediatric audiologic assessment (including conditional response audiometry, play audiometry, and soundfield response assessment); electrophysiologic audiologic measures (including electroencephalographic, brainstem and electrocochleographic procedures); hearing aid evaluation and selection; audiologic hibilitation (including hearing aid orientation, counseling, analysis of auditory processing abilities, auditory and visual communication training, speech, language and hearing therapy); and audiologic technical services including hearing aid adjustment, electroacoustic evaluation, noise survey, special report writing, etc.).

(iv) Data source. The number of procedures shall be obtained from an actual count maintained by the Audiology cost center.

(6) 7590 OTHER PHYSICAL MEDICINE

(i) Function. Other Physical Medicine includes educational and therapeutic activities related to the treatment, habilitation and rehabilitation of patients with neuromuscular and musculoskeletal impairments. Include milieu therapy in this cost center. Such activities are those not required to be included in the Physical Therapy, Occupational Therapy, Speech-Language Pathology, Recreational Therapy and Audiology cost centers.

(ii) Description. This cost center contains the direct expenses incurred in providing physical medicine activities not specifically required to be included in another cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment.

(iv) Data source. The number of treatments shall be obtained from an actual count maintained by the Other Physical Medicine cost center.

(7) 7670 PSYCHIATRIC/PSYCHOLOGICAL SERVICES ..........................................................................................................

7671 Individual Therapy..........................................................................................................

7672 Group Therapy..........................................................................................................

7673 Family Therapy..........................................................................................................

7674 Biofeedback Training..........................................................................................................

7675 Psychological Testing..........................................................................................................

7676 Shock Therapy..........................................................................................................

7689 Other Psychiatric/Psychological Services..........................................................................................................

(i) Function. This cost center provides psychiatric and psychological services such as individual, group and family therapy to adults, adolescents and families; biofeedback training; psychological testing; and shock therapy.

(ii) Description. This cost center contains the direct expenses incurred in providing psychiatric and psychological services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(iii) Standard Units of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. For group sessions, count as one treatment each patient participating in the session.

(iv) Data source. The number of treatments shall be obtained from an actual count maintained by this service.

(m) 7710 RENAL DIALYSIS..........................................................................................................

7711 Hemodialysis..........................................................................................................

7713 Peritoneal Dialysis..........................................................................................................

7715 Patient Dialysis Training..........................................................................................................

7719 Other Dialysis..........................................................................................................

(1) Function. Renal Dialysis is the process of cleaning the blood by the use of an artificial kidney machine or other method. Additional activities include, but are not limited to, the following:

Wheeling portable equipment to patient's bedside; explaining procedures to patient; operating dialysis equipment; inspecting, testing and maintaining special equipment.

(2) Description. This cost center contains the direct expenses incurred in providing inpatient and outpatient Renal Dialysis services in the hospital. Report all Home Program Dialysis expenses in accounts 6810 and 6820, as appropriate. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.

(3) Standard Unit of Measure: number of treatments. Count each treatment for which a charge is made as one treatment regardless of the length of the treatment.

(4) Data source. The number of treatments shall be the actual count maintained by the Renal Dialysis cost center.

(n) 7730 KIDNEY ACQUISITION

(1) Function. This cost center acquires, stores and preserves all human kidneys for eventual transplantation. Unlike other ancillary services, the total cost of kidney acquisition is not accumulated in any one patient care cost center. Therefore, only the costs which are not properly includable in another cost center are to be included in this cost center.

(2) Description. This cost center contains the direct expenses incurred in acquiring, storing and preserving human kidneys. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: number of kidneys acquired. Count each kidney acquired as one.

(4) Data source. The number of kidneys acquired shall be the actual count maintained by the Kidney Acquisition cost center.

(o) 7750 OTHER ORGAN ACQUISITION

(1) Function. This cost center acquires, stores and preserves all human organs (except kidneys) for eventual transplantation. Unlike other ancillary services, the total cost of organ acquisition is not accumulated in any one patient care cost center. Therefore, only the costs which are not properly includable in another cost center are to be included in this cost center.

(2) Description. This cost center contains the direct expenses incurred in acquiring, storing and preserving human organs. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

(3) Standard Unit of Measure: number of organs acquired. Count each organ acquired as one.

(4) Data source. The number of organs acquired shall be the actual count maintained by the Organ Acquisition cost center.

(p) 7910 OTHER ANCILLARY SERVICES. This cost center contains the direct expenses incurred in providing ancillary services other than those required to be included in other specific cost centers. Included are expenses incurred in providing formal education to school age psychiatric inpatients. Related revenue must be included in the Other Ancillary Services revenue center (account 4910). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.

N.Y. Comp. Codes R. & Regs. Tit. 10 § 444.20