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Ask A Rev Cycle Expert: Billing for Rental Equipment?

Question:

Is it appropriate to bill for rental equipment as a supply charge separately from the procedure charge? For instance, lithotripsy machine rented for an Extracorporeal Shock Wave Lithotripsy (ESWL) procedure?


Answer:

Costs of equipment are not separately chargeable and should be built into the cost of the procedure because the equipment is integral to the procedure performed.

Provider Reimbursement Manual Part 1, Chapter 22 Determination of Cost of Services

“2202.6 Routine Services.--Inpatient routine services in a hospital or skilled nursing facility generally are those services included in by the provider in a daily service charge--sometimes referred to as the "room and board" charge. Routine services are composed of two board components; (l) general routine services, and (2) special care units (SCU's), including coronary care units (CCU's) and intensive care Units (ICU's). Included in routine services are the regular room, dietary and nursing services, minor medical and surgical supplies, medical social services, psychiatric social services, and the use of certain equipment and facilities for which a separate charge is not customarily made.

In recognition of the extraordinary care furnished to intensive care, coronary care, and other special care hospital inpatients, the costs of routine services furnished in these units are separately determined. If the unit does not meet the definition of a special care unit (see § 2202.7), then the cost of such service cannot be included in a separate cost center, but must be included in the general routine service cost center. (See § 2203.l for further discussion of routine services in an SNF.)

2202.8 Ancillary Services.--Ancillary services in a hospital or SNF include laboratory, radiology, drugs, delivery room (including maternity labor room), operating room (including postanesthesia and postoperative recovery rooms), and therapy services (physical, speech, occupational). Ancillary services may also include other special items and services for which charges are customarily made in addition to a routine service charge. (See §2203.1 and §2203.2 for further discussion of ancillary services in an SNF.)"

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