The Assistant Secretary of Defense for Health Affairs (ASD/HA) approved the implementation of Calendar Year 2013 Outpatient Medical, Dental, and Cosmetic Procedure Reimbursement rates for direct care military treatment facilities (MTFs) as of 1 July 2013. These rates are used to determine charges for medical and dental services provided on an outpatient basis as well as both ambulatory and inpatient cosmetic services. These rates were released in accordance with Title 10 United States Code (USC) Section 1095.
The ASD(HA) also approved the Fiscal Year 2014 Inpatient Billing Rates for direct care MTFs effective 1 October 2013. These rates are used to determine charges for inpatient professional and institutional healthcare services provided in MTFs under the Defense Health Program (DHP). They are also released in accordance with Title 10 USC Section 1095.
Specific rates can be accessed on one of the MHS Rates subpages from the main navigation pane.
Among the reasons we publish UBO rates on this Web site is to comply with Executive Order 13410, 22 August 2006. One purpose of this Executive Order is to promote healthcare transparency regarding healthcare quality and price. The below link will allow you to download the full text.
Executive Order 13410 pdf 98.5 KB
UBO billing systems use rate files in conjunction with several mapping tabes that direct the billing systems to the appropriate rate file for a given procedure, specify the billing form for each procedure, provide appropriate revenue centers for each procedure, and provide appropriate modifiers for each procedure. The major mapping files are linked below.
CY13 Mapping Tables (posted 7-1-2013)
CY13 TPOCS Mapping Table xls 5643.0 KB
CY13 DMIS ID to CMAC Locality Table xlsx 440.1 KB
CY13 Modifier Mapping Table xls 372.0 KB (Effective 1 Jan 2013)
CY13 Revenue Mapping Table xls 6688.0 KB
For questions or comments, please e-mail UBO.Helpdesk@altarum.org, or leave a message for the Helpdesk staff at (571) 733-5935. Phone messages will be returned within one business day.