Program Pricing
The Children’s Center Rehabilitation Hospital (TCCRH) Inpatient Consumer Price Transparency
Updated 12.31.2020
The Children’s Center Rehabilitation Hospital (TCCRH) charges all patients and payers on a per day basis. The per diem charge is inclusive of all services, including professional and ancillary services, provided during an inpatient stay. There are four levels of service that are provided to our patients. The level of service is determined by the medical criteria of the payer, based on established clinical guidelines, and based on TCCRH clinical assessment of our patients.
Services are billed and reimbursed primarily based on Revenue Code. However, a Revenue Code can apply across multiple levels of services provided. Arrangements are made with each specific payer as to the recognized Revenue Code for reimbursement purposes.
All private pay billing is at the Standard Hospital Charge. TCCRH does not have a set Discounted Cash Price that is offered to self-pay patients. On a case-by-case basis, TCCRH works with individual patients to determine expected payment.
| Level of Services | Standard Hospital Charge | Private Pay Patients | De-identified Minimum Negotiated Charge | De-identified Maximum Negotiated Charge | Aetna | Blue Cross and Blue Shield of Oklahoma | Cigna | Healthcare Highways | United Health Care |
| Long-term Acute Care Hospital (LTAC) Services | 2182 | 2182 | 1000 | 1704 | 1190 | 1284 | 1000 | 1500 | 1704 |
| Inpatient Rehabilitation Services | 2047 | 2047 | 1070 | 1500 | 1500 | 1070 | 1200 | 1450 | 1340 |
| Medical/Surgical Services | 1636 | 1636 | 1100 | 1340 | 1190 | * N/A | * N/A | 1100 | 1340 |
| Subacute Care/Skilled Nursing Services | 1365 | 1365 | 749 | 1050 | 951 | 749 | 900 | 1050 | 1004 |
* Note: Payers are not contracted for all levels of care. In that case, “N/A” for Not Applicable is indicated.
The Children’s Center Rehabilitation Hospital (TCCRH) Outpatient Consumer Price Transparency
Updated 11.1.2021
| Outpatient Program Pricing | ||
|---|---|---|
| Office Visits | ||
| Procedure Code | Code Description | Fee Schedule |
| 99202 | New patient straightforward medical decision making | 80.43 |
| 99203 | New patient low level of medical decision making | 124.46 |
| 99204 | New patient moderate level of medical decision making | 186.93 |
| 99205 | New patient high level of medical decision making | 247.1 |
| 99212 | Established patient straightforward medical decision making | 61.85 |
| 99213 | Established patient low level of medical decision making | 101.25 |
| 99214 | Established patient moderate level of medical decision making | 144.04 |
| 99215 | Established patient high level of medical decision making | 201.65 |
| 99381 | New patient preventive medicine, infant less than 1 year old | 122.61 |
| 99382 | New patient preventive medicine, age 1 through 4 years | 128.14 |
| 99383 | New patient preventive medicine, age 5 through 11 years | 133.26 |
| 99384 | New patient preventive medicine, age 12 through 17 years | 150.11 |
| 99391 | Established patient preventive medicine, infant less than 1 year old | 110.19 |
| 99392 | Established patient preventive medicine, age 1 through 4 years | 117.94 |
| 99393 | Established patient preventive medicine, age 5 through 11 years | 117.58 |
| 99394 | Established patient preventive medicine, age 12 through 17 years | 128.94 |
| Speech Therapy/Physical Therapy/Occupational Therapy | ||
| Procedure Code | Code Description | Fee Schedule |
| 92507 | Treatment of speech, language, voice, communication and/or auditory processing disorder | 90.43 |
| 92523 | Evaluation of speech sound production with evaluation of language comprehension and expression | 220.19 |
| 92526 | Treatment of swallowing dysfunction and/or oral function for feeding | 99.23 |
| 92610 | Evaluation of oral and pharyngeal swallowing function | 98.65 |
| 97110 | Therapeutic procedure to develop strength and endurance, range of motion and flexibility (each 15 minutes) | 34.71 |
| 97112 | Therapeutic procedure neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities (each 15 minutes) | 39.81 |
| 97116 | Therapeutic procedure gait training (each 15 minutes) | 34.34 |
| 97161 | Physical therapy evaluation: low complexity | 96.68 |
| 97162 | Physical therapy evaluation: moderate complexity | 96.68 |
| 97163 | Physical therapy evaluation: high complexity | 96.68 |
| 97165 | Occupational therapy evaluation: low complexity | 102.29 |
| 97166 | Occupational evaluation: moderate complexity | 101.91 |
| 97167 | Occupational therapy evaluation: high complexity | 101.91 |
| 97530 | Therapeutic activities, direct patient contact | 44.01 |
| 97533 | Sensory integrative techniques to enhance sensory processing and promote adaptive responses to envionmental demands (each 15 minutes) | 57.31 |
| 97535 | Self-care/home management training (each 15 minutes) | 38.45 |