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HCPCS D0160

EXTENSV ORAL EVAL PROB FOCUS

Reported by 8 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$85

Average

$125

Median

$124

High

$187

Hospitals reporting this code

#HospitalLocation
1Ukiah Adventist HospitalUkiah, CA$79$88$85$505$4
2Adventist Health Medical Center TehachapiTehachapi, CA$87$114$114$685$6
3Sonora Community HospitalSonora, CA$104$139$134$310$7
4Reedley Community HospitalReedley, CA$87$96$93$676$5
5Lodi Memorial Hospital Association IncLodi, CA$54$187$187$304—
6Willits Hospital IncWillits, CA$108$135$135$407—
7National Rehabilitation HospitalWashington, DC$126$154$154$230—
8MedStar Washington Hospital CenterWashington, DC$69$99$99$203—

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