Patient Care

Cost Accounting by Function - Function Definitions
Patient Care
(Last Updated 10/07/2004)

Payroll Object Code	FIS A-21 Category Code (424 Code)	FIS Function Code (450 Code)	Space Indirect Cost (IDC) Code
15	01	15	95

Patient care includes services to individual patients that are normally eligible to be billed to patients or third parties.

A useful distinction is included in the Medicare regulations which separate services eligible for payment under Part A Trust Funds (hospital management services and supervision of residents and interns) and those eligible for payment under Part B Trust Funds (included here). Another useful test is the extent to which the community practitioners in the same specialty or subspecialty are commonly engaged. This includes professional, technical and support staff services. For additional information on Medicare Part A Trust Funds and Medicare Part B Trust Funds, visit the CMS web site.

Included are:
(a) All services billable to Medicare Part B or covered under commercial insurance as physician services.

(b) Training or professional development activities which are intended to improve clinical skills.

(c) "Clinical marketing" activities intended to establish our (Washington University School of Medicine) medical practices as regional leaders in applying clinical knowledge to patient care.

(d) Some technical services such as renal dialysis and ultra sound when reimbursed by the hospital.

(e) Patient care services performed by fellows that are not in an ACGME accredited program.

(f) Support staff personnel performing clinical administrative functions. These include:

billing
collections
labs used specifically for patient care
scheduling
other administrative activities

(g) Managed care duties associated with managing professional risk contracts.

Excluded are:
(a) Activities related to supervising and instructing persons in accredited internship or residency programs (see Object Codes 16, 18, 19).

(b) Activities associated with the management of hospital services or administration of hospital activities (Object Codes 56, 58, 59).

(c) Patient care activities which are associated with organized research projects (see Object Code 20).

(d) Cost sharing allocation charges (budget 50 debits) related to research-oriented sponsored projects. Department accounts that support cost sharing should be Department Research accounts.

Please send your comments to: FinanceComments@msnotes.wustl.edu