MEDICAL EXPENSE AND PERFORMANCE …

1 DoD MEDICAL EXPENSE AND PERFORMANCE reporting SYSTEM FOR FIXED MILITARY MEDICAL AND DENTAL TREATMENT FACILITIES MANUAL April 7, 2008 Incorporating Change 2, Effective April 15, 2014 OFFICE OF THE ASSISTANT SECRETARY OF DEFENSE HEALTH AFFAIRS DoD , April 7, 2008 Change 2, 04/15/2014 2 FOREWORD This manual is issued under the authority of Department of Defense (DoD) Directive (Reference (a)). It prescribes the procedures for the uniform reporting of EXPENSE and labor hour data for fixed military MEDICAL and dental treatment facilities. DoD , MEDICAL EXPENSE and PERFORMANCE reporting System for Fixed Military MEDICAL and Dental Treatment Facilities, November 21, 2000 (Reference (b)), is hereby canceled.

2 This manual applies to the Office of the Secretary of Defense, the Military Departments, the Office of the Chairman of the Joint Chiefs of Staff, the Combatant Commands, the Office of the Inspector General of the Department of Defense, the Defense agencies, the DoD Field Activities, and all other organizational entities in DoD (hereafter referred to collectively as the DoD Components ). This manual does not apply to DoD facilities that are not involved in direct patient care ( , MEDICAL research facilities), DoD facilities for field service ( , force combat support and evacuation hospitals), facilities afloat ( , hospital ships and sick bays aboard ships), and tactical casualty staging facilities ( , MEDICAL advance base staging facilities and MEDICAL advance base components contained within mobile-type units).

3 This manual is effective April 7, 2008 and is mandatory for use by all the DoD Components. It must be reissued, cancelled, or certified current within 5 years of its publication in accordance with DoD Instruction (Reference (s)). If not, it will expire effective April 7, 2018 and be removed from the DoD Issuances Website. Send recommended changes to this manual to the following address. TRICARE Management Activity Office of the Chief Financial Officer, Management Control and Financial Studies 5111 Leesburg Pike, Suite 810 Falls Church, VA 22041-3206 Defense Health Agency Business Support Directorate/Budget and Resource Management Division 7700 Arlington Blvd.

4 , Suite 5101 Falls Church, VA 22042 This manual is approved for public release; distribution is unlimited. Copies are available via the Internet at S. Ward Casscells, MD DoD , April 7, 2008 Change 2, 04/15/2014 3 TABLE OF CONTENTS Page FOREWORD ..2 TABLE OF CONTENTS ..3 TABLES ..5 REFERENCES ..6 DEFINITIONS ..7 ABBREVIATIONS AND ACRONYMS ..18 C1. CHAPTER 1 GENERAL INFORMATION ..21 INTRODUCTION ..21 ORGANIZATION OF THE MEDICAL EXPENSE AND PERFORMANCE reporting SYSTEM (MEPRS) MANUAL ..23 C2. CHAPTER 2 CHART OF FUNCTIONAL COST CODE (FCC) INPATIENT CARE ..25 AMBULATORY CARE ..46 DENTAL CARE ..79 ANCILLARY SERVICES.

5 81 SUPPORT SERVICES ..108 SPECIAL PROGRAMS ..145 READINESS ..170 C3. CHAPTER 3 MEPRS GUIDELINES AND reporting REQUIREMENTS ..183 PURPOSE ..183 EXPENSE ALLOCATION METHODOLOGY ..183 reporting C4. CHAPTER 4 MEPRS ISSUE PROCESS ..196 PURPOSE ..196 POLICY ..196 RESPONSIBILITIES FOR ISSUE IDENTIFICATION AND RESOLUTION ..196 ISSUE IDENTIFICATION ..197 ISSUE RESOLUTION PROCESS..197 DoD , April 7, 2008 Change 2, 04/15/2014 4 PHASE 1 INITIATION PROCESS ..197 PHASE 2 INITIAL REVIEW AND TRACKING PROCEDURES ..198 PHASE 3 ISSUE COORDINATION AND RESOLUTION ..199 PHASE 4 FINAL DISPOSITION OF ISSUE AND PRIORITIZATION OF SYSTEM CHANGE REQUESTS (SCR).

6 199 PROCESSING PROCEDURES ..200 APPENDICES ..201 AP1. STANDARD FCC AP2. EXPENSE ASSIGNMENT SYSTEM (EAS) IV DATA ELEMENTS ..233 AP3. SPECIFIC RULES FOR reporting AVAILABLE AND NON-AVAILABLE TIME/HOURS FOR MEPRS/EAS ..250 AP4. MEPRS ISSUE PAPER RESOLUTION FORMAT ..261 DoD , April 7, 2008 Change 2, 04/15/2014 TABLES 5 TABLES Table Title Page Pharmacy Weighted Procedures ..83 Laboratory Weighted Values ..85 Radiology Weighted Procedure ..88 DJ MEPRS/Composite Healthcare System (CHCS)/Armed Forces Health Longitudinal Technology Application (AHLTA) A -Level Intensive Care Unit (ICU) Code.

7 105 Depreciation Distribution ..110 Inpatient Clinical Nutrition Weighted Procedures ..140 Skill Types ..184 Full-Time Equivalents (FTEs) ..184 Alignment of Intermediate Operating EXPENSE Accounts ..194 Standard FCC Accounts ..205 Specific Rules for reporting Available and Non-Available Time in Fixed MEDICAL and Dental Facilities ..252 DoD , April 7, 2008 Change 2, 04/15/2014 6 REFERENCES REFERENCES (a) DoD Directive , Health Services Support, January 6, 2011, as amended (b) DoD , MEDICAL EXPENSE and PERFORMANCE reporting System for Fixed Military MEDICAL and Dental Treatment Facilities, November 21, 2000 (hereby canceled) (c) DoD , Glossary of Healthcare Terminology, January 13, 1999 (d) Joint Publication 1-02, Department of Defense Dictionary of Military and Associated Terms, current edition (e) DoD , Department of Defense Financial Management Regulations (FMRs), Glossary, and Volumes 1, 2A, 3, 4, 6A, 10, 11A, and 11B, current edition (f)

8 TRICARE Management Activity, Office of the Chief Financial Officer, Business and Economic Analysis Division, Military Health System Coding Guidance: Professional Services and Specialty Coding current edition (g) Sections 1101, 1341 and 1517 of title 31, United States Code (h) DoD Instruction , Accountability and Management of DoD Equipment and Other Accountable Property, May 19, 2011 (i) DoD Instruction , Provision of Early Intervention and Special Education Services to Eligible DoD Dependents, April 11, 2005 (j) Chapter 47 and sections 2801-2813 of title 10, United States Code (k) MEDICAL Group Management Association Guide, RVUs: Applications for MEDICAL Practice Success, 2nd Edition, January 2003 (l) Office of Management and Budget Circular A-123, Management s Responsibility for Internal Control, December 21, 2004 (m) DoD , Department of Defense Procedures for Management of Information Requirements, June 30, 1998 (n) DoD Directive Instruction , Data Sharing in a Net-Centric Department of Defense Sharing Data, Information, and Information Technology (IT) Services in the Department of Defense, December 2, 2004 August 5, 2013 (o) Section 1400 of title 20, United States Code (p) Under Secretary of Defense (Comptroller)

9 Web Site, Military Personnel Composite Standard Pay and Reimbursement Rates, (q) DoD Instruction , Military Health System Data Quality Management Control Procedures, November 26, 2002 (r) Joint Federal Travel Regulations, Volumes 1 and 2, Uniformed Service Members, and Department of Defense Civilian Personnel, current editions (s) DoD Instruction , DoD Directives Program, October 28, 2007 September 26, 2012, as amended DoD , April 7, 2008 Change 2, 04/15/2014 7 DEFINITIONS DEFINITIONS DL1. The following terms are defined in DoD (Reference (c)). Admission. Aeromedical Staging Facility. Ambulatory Care.

10 Ambulatory Procedure Unit (APU). Ancillary Services. Assignment Factor. Average Daily Patient Load (ADPL). Average Length of Stay (ALOS). Bassinet Day. Borrowed Labor. Clinic. Clinician. Complete Physical Examination. Continuing Education (CE). Convalescent Leave. Cost Assignment. Cost Pool. Death. Delivery. Dental Clinic. DoD , April 7, 2008 Change 2, 04/15/2014 8 DEFINITIONS Facility. FTE. FTE Work-Month. Graduate MEDICAL Education (GME). Healthcare Professional. Hospital. Hours or Minutes of Service or Treatment. Inpatient Care.