Total Gross Fee-for-Service charges due from patients or third parties, arranged according to the appropriate age category.

These do not include:

• Capitated charges
• Capitation payments due from HMOs
• Any other incentive or bonus payments due from HMOs or other third parties
• Amounts turned over to a collection agency, or written off as bad debt

The difference between the Gross Fee-For-Service charges, and the amount expected to be paid by patients and third party payers. This would include Medicare/Medicaid charge restrictions. This would also include discounts given to third party payers, charitable work, professional courtesy, and employee discounts. Do not include any allowance for bad debts.

Any difference between what the practice expects to collect (Gross Charges less adjustments), and what the practice actually collects. Typically, a practice will make an allowance for bad debt expense based on past history of collections.

• Rental, operating lease and leasehold improvements for buildings and grounds
• Depreciation cost for buildings and grounds
• Interest paid on loans for real estate used in practice operations
• Utilities, water, electric, fuels, etc.
• Supplies and materials used in housekeeping and maintenance
• Other costs such as building repairs and security systems

C, D

E

Encounters

An encounter is a procedure from the evaluation and management or the medicine chapter of the Physicians' Current Procedural Terminology of the American Medical Association.
Include the following CPT codes:

Evaluation & Management services:

• 99201-99215, office visits
• 99241-99245, office or outpatient consultations
• 99271-99275, confirmatory consultations
• 99354-99360, prolonged services
• 99361-99373, case management services
• 99375-99376, care plan oversight services
• 99381-99429, preventive medicine services
• 99431-99432, newborn care
• 99450-99499, special and other services

Radiology services (given an appropriate location code):

• 77261-77799, radiation oncology
• 79000-79999, therapeutic nuclear medicine

Medicine services (given an appropriate location code):

• 90700-99090
• 99175-99199

F

Full Time Equivalent

A full time equivalent works whatever the practice considers to be the minimum for a normal work week. If the normal work week is 40 hours, and an employee works 30 hours, that employee would be considered 0.75 Full-Time-Equivalent.

• The value of purchased services (services purchased by providers outside of the practice)
• Charges for Fee-For-Service services allowed under the terms of the capitation contract

The full value at the practice's undiscounted rates to all fee-for-service patients for all services rendered by the practice. Do not include charges for capitation patients.

• Local and long-distance telephone, paging, and answering service
• Rental or depreciation cost of major data processing, computer and telecommunication equipment, hardware and software subject to capitalization
• Cost of data processing services purchased from an outside vendor
• Hardware and software repair and maintenance contract cost
• Cost of data processing supplies and minor software and equipment not subject to capitalization

• Cost of chemotherapy drugs, vaccines, allergy drugs, etc.
• Cost of medical/surgical supplies and instruments
• Cost of laundry and linens

• Audiologist
• Certified/registered nurse anesthetist
• Dietician/Nutritionist
• Midwife
• Nurse practitioner
• Occupation therapist
• Optometrist
• Physician assistant
• Physical therapist
• Physician assistant (non-surgical, non-primary care)
• Podiatrist
• Psychologist
• Social worker
• Speech therapist
• Surgeon's assistant

• Payroll taxes
• Health, life, disability, and workers compensation insurance
• Employers contribution to retirement and profit sharing
• Dues, memberships and licenses
• Meetings, travel, CME
• Other benefits, such as automobile, country/athletic memberships, travel for spouse, etc.

Do not include expense reimbursements.

• Withholds
• Incentive funds
• Utilization management fees
• Co-payments made for capitation patients

Exclude:
Purchased services for capitation patients. This would be fees paid to any healthcare provider outside the practice for services rendered to capitation patients under the terms of the practice's capitation contracts.

The total number of covered lives under capitation plans.

Number of days spent in hospitals in a given month by the capitated members of the practice.

Include only days for acute care.

Do not include days spent in an outpatient surgical center or skilled nursing facility.

Calculate the full-time equivalents of practice support staff, based on a 40-hour work week. Include contracted support staff. To estimate support staff Full-Time-Equivalents, divide the cost of the support staff by the average cost including benefits of your staff, or estimate the number of hours worked in the practice by the contracted support staff.

Include other miscellaneous practice expenses not included in any other field above.

• Allergy/Immunology
• Anesthesiology
• Cardiology
• Critical Care
• Dentistry
• Dermatology
• Emergency medicine
• Endocrinology
• Family practice
• Gastroenterology
• Genetics
• Geriatrics
• Gynecology
• Gynecological oncology
• Hematology/Oncology
• Infectious disease
• Internal medicine
• Neonatal medicine
• Neurology
• Nephrology
• Nuclear medicine
• Obstetrics
• Occupational medicine
• Opthamology
• Otorhinolaryngology
• Pathology
• Pediatrics
• Physical medicine
• Psychiatry
• Pulmonology
• Radiation oncology
• Radiology
• Reproductive endocrinology
• Rheumatology
• Surgery (all specialties)
• Urology

• Payroll taxes
• Health, life, disability, and workers compensation insurance
• Employers contribution to retirement and profit sharing
• Dues, memberships and licenses
• Meetings, travel, CME
• Other benefits, such as automobile, country/athletic memberships, travel for spouse, etc.

Do not include expense reimbursements.

• Payroll taxes
• Health, life, disability, and workers compensation insurance
• Employers contribution to retirement and profit sharing

Do not include expense reimbursements.

Include contracted support staff, defined as personnel employed by a practice management company, management services organization, billing or collections company, and/or other contracted support services organizations. In short, include all personnel who conduct support staff tasks on behalf of the practice.

Include all costs to the practice, i.e., all provider and non-provider expenses.

U, V, W, X, Y, Z