| Service Billed to FIs (HCPCS) |
Number of Claims in Sample |
Dollars Underpaid in Sample |
Total Dollars Paid in Sample |
Projected Dollars Underpaid |
Underpymt Rate |
/
|
/
|
/
|
/
|
/
|
/
|
| SNF-outpatient (HHA-A also) (23) |
171 |
$25 |
$56,359 |
$183,828 |
0.10% |
| Hospital-outpatient (HHA-A also)(under OPPS 13X must be used for ASC claims submitted for OPPS payment -- eff. 7/00) (13) |
36,629 |
$43,192 |
$12,124,768 |
$78,098,211 |
0.30% |
| Special facility or ASC surgery-hospice (non-hospital based) (81) |
879 |
$5,287 |
$2,286,149 |
$18,336,592 |
0.20% |
| SNF-inpatient (including Part A) (21) |
1,523 |
$7,488 |
$7,168,151 |
$15,247,258 |
0.10% |
| HHA-inpatient or home health visits (Part B only) (32) |
1,090 |
$4,079 |
$2,492,134 |
$12,800,989 |
0.10% |
| HHA-outpatient (HHA-A also) (33) |
702 |
$3,688 |
$1,692,300 |
$11,701,399 |
0.20% |
| Clinic-hospital based or independent renal dialysis facility (72) |
1,264 |
$5,033 |
$2,845,139 |
$4,475,321 |
0.10% |
| Special facility or ASC surgery-rural primary care hospital (eff 10/94) (85) |
5,771 |
$2,677 |
$1,991,621 |
$3,508,209 |
0.10% |
| SNF-inpatient or home health visits (Part B only) (22) |
899 |
$411 |
$429,695 |
$1,025,012 |
0.10% |
| Hospital-inpatient (including Part A) (11) |
506 |
$1,341 |
$3,377,831 |
$751,070 |
0.00% |
| Clinic-ORF only (eff 4/97); ORF and CMHC (10/91 - 3/97) (74) |
838 |
$210 |
$243,031 |
$578,581 |
0.10% |
| Clinic-CORF (75) |
143 |
$28 |
$62,015 |
$193,832 |
0.10% |
| Hospital-other (Part B) (14) |
7,302 |
$57 |
$227,254 |
$69,382 |
0.00% |
| All Other Codes |
4,563 |
$0 |
$1,895,206 |
$0 |
0.00% |
| Combined |
62,280 |
$73,518 |
$36,891,654 |
$146,969,684 |
0.20% |
|
|