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					NY State Medicaid EHR Incentive Workbook for Hospitals
The purpose of this workbook is to assist hospitals to verify eligibility and calculate incentive payments prior to utilizing the M


Included Worksheets

Hospital Eligibility Worksheet                                         This worksheet can be used to determine if an acute care
                                                                       Program. Children's hospitals are automatically qualified
Eligible Hospital Incentive Payment Calculation Worksheet              This worksheet will guide an eligible hospital through the
                                                                       amount. The worksheet will automatically calculate the I
                                                                       completed.
Glossary of Terms                                                      This worksheet provides a comprehensive list of terms us


Charges & Charity Care                                                 This worksheet provides a comprehensive list of class cod
                                                                       in the calculation of Total Charges and Total Charity Care
For questions regarding completion of this workbook please contact 1 (800) 278-3960 or hit@health.state.ny.us
ospitals
 ayments prior to utilizing the MEIPASS online system to apply for the EHR Incentive Program.




ed to determine if an acute care hospital meets the minimum eligibility requirement for the EHR Incentive
 tals are automatically qualified for the program based on the Federal Guidelines.
 an eligible hospital through the data collection requirements for determining the EHR Incentive Payment
will automatically calculate the Incentive Payment values once the required data fields have been


a comprehensive list of terms used in the NY State Medicaid EHR Incentive Workbook for Hospitals.


a comprehensive list of class codes from Exchibit 46 of the Institutional Cost Report that may be included
 Charges and Total Charity Care Charges.
 health.state.ny.us

                                                                            Last Modified 03/09/2012 v 3.2
                                                          Hospital Eligibility Worksheet
Section 1: Data Inputs for Eligible Hospital Determination
Please enter in the requested values for the data elements in Section 1.

*Data must be derived from an auditable data source. Help text with definitions and guidance is available by poi
are marked with a red tab.

                     Application Dates
                                         Payment Year

                                         Hospital Fiscal Year

                                         Base Year

                                         Patient Volume Reporting Period (90 Day Reporting Period)



               Patient Encounter Data
                                         Patient Volume Reporting Period (90 Day Reporting Period)

                                         Acute Care Inpatient Hospital Encounters

                                         Emergency Department Encounters

                                         Medicaid Inpatient Hospital Encounters

                                         Medicaid Emergency Department Encounters

                                         Total Acute Care Inpatient Bed Days (For 12 month period)

                                         Total Acute Care Discharges (For 12 month period)


Section 2: EHR Incentive Program Determination

The worksheet will use the data captured in Section 1 to determine if a hospital meets the minimum eligibility re
Incentive Program. Additional information about each data element is available by pointing your mouse to the f
Total Patient Encounters

Total Medicaid Encounters

Medicaid Patient Volume

Average Patient Stay in Days

Hospital meets Eligibility Requirements for the EHR Incentive
Program
idance is available by pointing your mouse to the field labels that




                                2012

                                         to

                                         to

                                         to




                                         to




 he minimum eligibility requirements for the Medicaid EHR
nting your mouse to the field label.
   0

   0

0.00%

 N/A


  No
                                             Eligible Hospital Incentive Payment Calculation Worksheet
Section 1: Data Inputs for Payment Calculation
Please enter in the values for the ten requested data elements in Section 1. The values captured in Section 1 will be used to populate the values in Se

*Data must be derived from an auditable data source. Help text with definitions and guidance is available by pointing your mouse to the field labels
tab.


                         Discharge and Financial Data
                                                        Base Year

                                                        Total Acute Discharges for Reporting Year


                                                        Total Acute Discharges for Prior Year 1


                                                        Total Acute Discharges for Prior Year 2


                                                        Total Acute Discharges for Prior Year 3


                                                        Medicaid Acute Inpatient Bed Days for Reporting Year
                                                    Total Acute Inpatient Bed Days for Reporting Year


                                                    Total Charity Care Charges


                                                    Total Charges

Section 2: Calculated Incentive Payment Data
The worksheet will calculate all of the values in the Incentive Payment Data section based on the input from Section 1. Additional information about
available by pointing your mouse to the field label.
                                                    Growth Rate Section
                                                                                                                  Current Year
                                                                                                                  Total Acute
                                                                                                                  Discharges
                                                    Total Acute Discharges for Current Year                                       0

                                                    Total Acute Discharges for Prior Year 1                                       0

                                                    Total Acute Discharges for Prior Year 2                                       0

                                                    Average Annual Growth Rate for Total Acute Discharges                    0.0%

                                                    Discharge Related Amount Section
                                                                                                                  Year 1
                                                    Estimated Acute Discharges Based On Calculated Growth Rate                    0

                                                    Discharge Related Amount                                                     $0

                                                    Total Discharge Related Amount                                               $0

                                                    Initial Amount Section
                                                                                                                  Year 1
                                                    Standard Base Amount                                                $2,000,000
Discharge Related Amount                                                $0

Initial Amount                                                  $2,000,000

Overall EHR Amount Section
                                                           Year 1
Initial Amount                                                   $2,000,000

Transition Factor                                                        1

EHR Amount Per Payment Year                                     $2,000,000

Total EHR Amount for 4 Years                                    $5,000,000

Non-Charity Care Ratio                                              100.00%

Medicaid Share Section
Medicaid Share                                                         0.0%

Medicaid EHR Hospital Incentive Payment for 4 Years                     $0

Medicaid EHR Incentive Program Payment Section
                                                           Year 1
Disbursement Percentage per NY agreement                              50.0%

Medicaid EHR Incentive Program Payment                                  $0

Total Medicaid EHR Incentive Program Payment for 4 Years                $0
orksheet
to populate the values in Section 2 automatically.

ur mouse to the field labels that are marked with a red




                                 to
dditional information about each data element is




          Prior Year Total
          Acute Discharges                    Growth Rate
                           0                             0.0%

                            0                           0.0%

                            0                           0.0%




          Year 2                Year 3        Year 4
                            0             0                0

                           $0            $0               $0




          Year 2              Year 3        Year 4
                   $2,000,000    $2,000,000       $2,000,000
                $0               $0              $0

         $2,000,000     $2,000,000       $2,000,000


Year 2                Year 3        Year 4
         $2,000,000      $2,000,000       $2,000,000

               0.75              0.5            0.25

         $1,500,000     $1,000,000         $500,000




Year 2                Year 3
             40.0%             10.0%

                $0               $0
                                                        Glossary of Terms
Acute Care Inpatient Hospital Encounters




Average Annual Growth Rate for Total Acute Discharges




Average Patient Stay in Days




Base Year




Disbursement Percentage per NY agreement


Discharge Related Amount




EHR Amount Per Payment Year
Emergency Department Encounters




Estimated Acute Discharges Based On Calculated Growth Rate




Hospital meets Eligibility Requirements for the EHR Incentive Program




Initial Amount
Medicaid Acute Inpatient Bed Days for Reporting Year




Medicaid EHR Hospital Incentive Payment for 4 Years


Medicaid EHR Incentive Program Payment
Medicaid Emergency Department Encounters




Medicaid Inpatient Hospital Encounters




Medicaid Patient Encounter




Medicaid Patient Volume




Medicaid Share
Non-Charity Care Ratio




Standard Base Amount

Total Acute Care Inpatient Bed Days (For 12 month period)

Total Acute Care Discharges (For 12 month period)

Total Charges




Total Charity Care Charges
Total Acute Discharges for Reporting Year




Total Acute Discharges for Prior Year 1
Total Acute Discharges for Prior Year 2




Total Acute Discharges for Prior Year 3
Total Acute Inpatient Bed Days for Reporting Year




Total Discharge Related Amount

Total EHR Amount for 4 Years

Total Medicaid EHR Incentive Program Payment for 4 Years




Total Medicaid Encounters


Total Patient Encounters


Transition Factor
 Glossary of Terms
The number of inpatient encounters in the Eligible Hospital for the 90-day reporting period. For the purposes of
the EHR Incentive Program, an inpatient encounter consists of an inpatient discharge from the eligible hospital.
Note that multiple discharges of an individual on different days count as multiple encounters. Transitions from
included units to sub-acute units not considered part of the eligible hospital (such as rehab, nursery, or skilled
nursing), or transitions from acute care to sub-acute care within a swing bed, are considered discharges from
the eligible hospital and thus may be counted as encounters.


The arithmetic mean of the growth rate in each of the three most recent reporting years (measured from the
previous year). (Growth Rate Current Year + Growth Rate Prior Year 1 + Growth Rate Prior Year 2) / 3


Calculated Average Patient Stay in Days (Total Acute Care Inpatient Bed Days / Total Acute Care Discharges).

An Average Patient Length of Stay of 25 Days or Fewer is Required for a hospital to be determined eligible.




The base year is the hospital reporting year used to determine eligibility of a hospital for participation in the NY
Medicaid EHR Incentive Program, which forms the basis for deriving the statistics that will determine the
amount of the incentive payments the hospital is eligible to receive.

According to rules promulgated by CMS, the data used in calculating eligibility and incentive payment amounts
is drawn from the “hospital cost report for the hospital fiscal year that ends during the Federal fiscal year prior
to the fiscal year that serves as the payment year.” 


Percentage of Total Medicaid EHR Incentive payment disbursed by the state each year according to the
disbursement schedule specified in the NY-SMHP.

The addition to each year's incentive payment based on the number of discharges from the Eligible Hospital,
calculated by multiplying $200 by the number of allowable discharges (discharges 1,150 thru 23,000). No
payment is made for discharges prior to the 1,150th discharge or for discharges after the 23,000th discharge.


EHR Incentive Payment amount calculated for each year, calculated as (Initial Amount × Transition Factor).
The number of patient encounters in the emergency department of the Eligible Hospital for the 90-day
reporting period. For the purposes of the EHR Incentive Program, an emergency department encounter consists
of any number of services rendered to an individual in an emergency department on any one day. Note that
emergency department services rendered to an individual on multiple days count as multiple encounters.


The estimated total number of discharges from the Eligible Hospital for a given future year, calculated using the
assumption that the Growth Rate in future years will be exactly equal to the Average Growth Rate observed in
the base year.

A determination (Yes / No) if the hospital meets the eligibility requirements for the Medicaid EHR Incentive
Program.

A hospital must have a Medicaid Patient Volume Percentage of at least 10% and Average Patient Length of Stay
of 25 Days or fewer in order to meet the eligibility requirements.


Initial Amount = Standard Base Amount of $2,000,000 + Discharge Related Amount

The Initial Amount is the sum of a base amount and a discharge-related amount. The base amount is
$2,000,000, and the discharge-related amount provides an additional $200 for estimated discharges between
1,150 and 23,000 discharges. No payment is made for discharges prior to the 1,150th discharge or for
discharges after the 23,000th discharge.
The number of bed days in the Eligible Hospital for the reporting year that were paid all or in part by Medicaid
(including Medicaid Managed Care and Family Health Plus, but not Child Health Plus). This MAY include bed days
where Medicaid paid for co-pays, premiums, or cost-sharing or where Medicaid was a secondary payer to
commercial insurance, but it MAY NOT include bed days where Medicare was the primary payer or where the
patient was a Medicaid beneficiary but Medicaid made no payment.

Source: ICR Exhibit 32

Derivation: Sum of Lines 014 and 200, less unpaid bed days, from each of the following Class Codes:
  • Class Code 4318 • Class Code 4500
  • Class Code 4496 • Class Code 4438*
  • Class Code 4388 • Class Code 4448*
  • Class Code 4458 • Class Code 4505†

ALSO add the sum of paid days from Lines 014 and 200 from Class Code 4468 (Other) if and only if the unit
reported in Class Code 4468 is considered acute under the Medicare IPPS.

The hospital may also add bed days where Medicaid made a non-zero payment as a secondary payer, provided
Medicare was not the primary payer. Additional documentation may be required.

Hospitals eligible to participate in the EHR Incentive Program as separately certified children’s hospitals that
report all bed days in Class Code 4488 under specific direction from the NYS Department of Health should use
the sum of Lines 014 and 200 from Class Code 4488.


Medicaid responsible portion of EHR Hospital Incentive Payment (Medicaid Share Percentage X Total EHR
Amount for 4 Years)

The amount of the EHR Incentive Program Payment for Year 1, Year 2 and Year 3.

Year 1 Payment= Medicaid EHR Hospital Incentive Payment for 4 Years × Disbursement Percentage per NY
agreement (50%)

Year 2 Payment= Medicaid EHR Hospital Incentive Payment for 4 Years × Disbursement Percentage per NY
agreement (40%)

Year 3 Payment= Medicaid EHR Hospital Incentive Payment for 4 Years × Disbursement Percentage per NY
agreement (10%)
The number of patient encounters in the emergency department of the Eligible Hospital for the 90-day
reporting period that were paid all or in part by Medicaid (including Medicaid Managed Care and Family Health
Plus, but not Child Health Plus). This MAY include encounters where Medicaid paid for co-pays, premiums, or
cost-sharing or where Medicaid was a secondary payer to commercial insurance; for the purposes of calculating
Medicaid patient volume to determine eligibility, it MAY also include encounters where Medicare was the
primary payer. It MAY NOT include encounters where the patient was a Medicaid beneficiary but Medicaid
made no payment. For a definition of emergency department encounters, see “Emergency Department
Encounters”.

The number of inpatient encounters in the Eligible Hospital for the 90-day reporting period that were paid all or
in part by Medicaid (including Medicaid Managed Care and Family Health Plus, but not Child Health Plus). This
MAY include encounters where Medicaid paid for co-pays, premiums, or cost-sharing or where Medicaid was a
secondary payer to commercial insurance; for the purposes of calculating Medicaid patient volume to
determine eligibility, it MAY also include encounters where Medicare was the primary payer. It MAY NOT
include encounters where the patient was a Medicaid beneficiary but Medicaid made no payment. For a
definition of inpatient encounters, see “Acute Care Inpatient Hospital Encounters”.


The following are considered Medicaid encounters for eligible hospitals:

(1) Services rendered to an individual per inpatient discharges where Medicaid or a Medicaid demonstration
project under section 1115 paid for part or all of the service;
(2) Services rendered to an individual per inpatient discharge where Medicaid or a Medicaid demonstration
project under section 1115 of the Act paid all or part of their premiums, co-payments, and/or cost-sharing;
(3) Services rendered to an individual in an emergency department on any one day where Medicaid or a
Medicaid demonstration project under section 1115 of the Act either paid for part or all of the service; or
(4) Services rendered to an individual in an emergency department on any one day where Medicaid or a
Medicaid demonstration project under section 1115 of the Act paid all or part of their premiums, co-payments,
and/or costsharing.




Calculated Medicaid Patient Volume Percentage (Total Medicaid Encounters / Total Patient Encounters).

A Medicaid Patient Volume Percentage of at least 10% is required for a hospital to be determined eligible.




Percentage of total acute inpatient bed days attributable to Medicaid patients, modified by the Non-Charity
Care Ratio as specified in statute.

The Medicare Share portion of the Medicaid hospital overall EHR amount is set at 1 by the statute.
Non-Charity Care Ratio is the proportion of total hospital charges that are not attributable to charity care,
calculated by subtracting Total Charity Care Charges from Total Charges and dividing by Total Charges.

(Total Charges − Total Charity Care Charges) / Total Charges


Statutory base incentive amount of $2,000,000 per payment year.

The total number of all unique inpatient bed days for the 12-month reporting period.

The total number of all unique discharges for 12-month reporting period.

The total dollar value of all hospital charges for the reporting year. According to rules and instructions
promulgated by CMS, Total Charges should be inclusive of all units in the hospital, including inpatient and
outpatient as well as acute and sub-acute units.

Source: ICR Exhibit 46 (Parts I & II)

Derivation: Sum of Line 200 from each of the Class Codes included in the State's Indigent Care Pool calculation.
See "Charges & Charity Care" tab for a complete list of Class Codes.

The total value of all charity care the hospital reported for the reporting year. Charity care results from a
provider’s policy to provide health care services free of charge (or where only partial payment is expected not to
include contractual allowances for otherwise insured patients) to individuals who meet certain financial criteria.
Charity care does not include contractual write-offs. Bed debt should not be included as a part of charity care
charges.

According to rules and instructions promulgated by CMS, the total charity care charges should be inclusive of all
units in the hospital, including inpatient and outpatient as well as acute and sub-acute units. Charity care
charges should be assessed at their full initial value prior to any deductions for payments received.

Source: ICR Exhibit 46 (Parts I & II)

Derivation: Sum of Line 313 from each of the Class Codes included in the State's Indigent Care Pool calculation.
See "Charges & Charity Care" tab for a complete list of Class Codes.
The total number of acute discharges from the Eligible Hospital for a given reporting year (Base Year). The data
must be for a full 12 months.

Source: ICR Exhibit 32

Derivation: Sum of Line 011 from each of the following Class Codes:
  • Class Code 4320 • Class Code 4501
  • Class Code 4497 • Class Code 4440*
  • Class Code 4390 • Class Code 4450*
  • Class Code 4460 • Class Code 4506†

ALSO add Line 011 from Class Code 4470 (Other) if and only if the unit reported in Class Code 4470 is considered
acute under the Medicare IPPS.

* 2009 ICR only
† 2010 ICR and later


The total number of acute discharges from the Eligible Hospital for the first year prior to the base year. The data
must be for a full 12 months.

Source: ICR Exhibit 32

Derivation: Sum of Line 011 from each of the following Class Codes:
  • Class Code 4320 • Class Code 4501
  • Class Code 4497 • Class Code 4440*
  • Class Code 4390 • Class Code 4450*
  • Class Code 4460 • Class Code 4506†

ALSO add Line 011 from Class Code 4470 (Other) if and only if the unit reported in Class Code 4470 is considered
acute under the Medicare IPPS.

* 2009 ICR only
† 2010 ICR and later
The total number of acute discharges from the Eligible Hospital for the second year prior to the base year. The
data must be for a full 12 months.

Source: ICR Exhibit 32

Derivation: Sum of Line 011 from each of the following Class Codes:
  • Class Code 4320 • Class Code 4501
  • Class Code 4497 • Class Code 4440*
  • Class Code 4390 • Class Code 4450*
  • Class Code 4460 • Class Code 4506†

ALSO add Line 011 from Class Code 4470 (Other) if and only if the unit reported in Class Code 4470 is considered
acute under the Medicare IPPS.

* 2009 ICR only
† 2010 ICR and later


The total number of acute discharges from the Eligible Hospital for the third year prior to the base year. The
data must be for a full 12 months.

Source: ICR Exhibit 32

Derivation: Sum of Line 011 from each of the following Class Codes:
  • Class Code 4320 • Class Code 4501
  • Class Code 4497 • Class Code 4440*
  • Class Code 4390 • Class Code 4450*
  • Class Code 4460 • Class Code 4506†

ALSO add Line 011 from Class Code 4470 (Other) if and only if the unit reported in Class Code 4470 is considered
acute under the Medicare IPPS.

* 2009 ICR only
† 2010 ICR and later
The total number of bed days in the Eligible Hospital for the reporting year (including all payment sources and
uncompensated care).

Source: ICR Exhibit 32

Derivation: Sum of Line 011 from each of the following Class Codes:
  • Class Code 4318 • Class Code 4500
  • Class Code 4496 • Class Code 4438*
  • Class Code 4388 • Class Code 4448*
  • Class Code 4458 • Class Code 4505†

ALSO add Line 011 from Class Code 4468 (Other) if and only if the unit reported in Class Code 4468 is considered
acute under the Medicare IPPS.

Hospitals eligible to participate in the EHR Incentive Program as separately certified children’s hospitals that
report all bed days in Class Code 4488 under specific direction from the NYS Department of Health should use
Line 011 from Class Code 4488.

* 2009 ICR only
† 2010 ICR and later


The sum of the Discharge Related Amounts for Year 1, Year 2, Year 3 and Year 4.

Sum of EHR Amount for Year 1 to Year 4

Total amount of Medicaid EHR Incentive Payment calculated for the eligible hospital.

(Medicaid Share × Total EHR Amount for 4 Years)

Calculated total number of Medicaid patient encounters for the 90-day reporting period (Medicaid Inpatient
Hospital Encounters + Medicaid Emergency Department Encounters).

Calculated total number of patient encounters for the 90-day reporting period (Acute Care Inpatient Hospital
Encounters + Emergency Department Encounters).

A scaling figure specified in the original legislation that is applied to each annual incentive payment amount.

This factor in the formula determines the Medicaid incentive payment to an eligible hospital. For each of the
four years of theoretical payment, a different transition factor applies. Note that for the Medicaid Program, an
aggregate EHR amount is calculated only once, and this amount is then spread over all years of a hospital’s
payments. Therefore, the transition factors are used to calculate the aggregate EHR amount but do not indicate
that the hospital’s payment will be recalculated on a yearly basis.
       Class Codes for Total Charges & Charity Care Charges

Description                                           Class Code
Inpatient Service Cost Center Line Assignments (99)
   Medical Surgical Inpatients                          0195
   Pediatric Unit                                       0094
   Maternity Unit                                       0095
   Epilepsy Unit                                        0182
   Psychiatric                                          3001
   Rehabilitation Medicine                              0093
   Traumatic Brain Injury/Coma                          3002
   Tuberculosis                                         0198
   H.I.V. Care                                          0193
   Chemical Dependency - Drug Rehab                     0181
   Chemical Dependency - Drug Detox                     3003
   Chemical Dependency - Alcohol Rehab                  0190
   Chemical Dependency - Alcohol Detox                  0371
   Bone Marrow Unit                                     3004
   Intensive Care Unit                                  0196
   Pediatric ICU                                        3005
   Cardiac ICU                                          3080
   Coronary Care Unit                                   0197
   Burn Intensive Care Unit                             0183
   Surgical Intensive Care Unit                         0184
   Neonatal Intensive Care Unit                         0194
   Traumatic Brain Injury/Coma                          3006
   Nursery - Premature                                  0024
   Any Additional Inpatient Component                 3021-3079
Outpatient Service Cost Center Line Assignment (98)
   Clinic                                               0026
   Alcohol Clinic                                       0387
Description                                                Class Code
   Alcohol Day Rehab Clinic                                  4830
   Chemotherapy Clinic                                       4831
   Day Hospital                                              4832
   Early Intervention                                        4833
   Family Clinic                                             4834
   Family Planning                                           4835
   Head Injury Clinic                                        4836
   H.I.V. Clinics                                            0388
   Hyperbaric Clinic                                         4837
   Oncology Clinic                                           4839
   Pediatric Clinic                                          4840
   Rehabilitation Clinic                                     4841
   Cardiac Rehabilitation Clinic                             4909
   Dental Clinic                                             4908
   Diabetes Clinic                                           4907
   PCAP Clinic                                               4906
   Sleep Clinic                                              4905
   Wound Care Clinic                                         4904
   Mental Health Clinic                                      0386
   Mental Health Continuing Day Treatment                    0108
   Mental Health Day Treatment                               0033
   Mental Health Intensive Psychiatric Rehab. Outpatient     0111
   Mental Health Partial Hosp.                               0112
   All Other OMH Programs O/P                                0106
   All Other OASAS Programs O/P                              0107
   Mental Health Outpatient ACT Programs                     4849
   Mental Health Outpatient ICM Programs                     4850
   Mental Health Outpatient SCM Programs                     4851
   Comprehensive PROS with Clinic                            4852
   Comprehensive PROS                                        4853
   Limited License PROS                                      4854
   PROS Rehabilitation and Support                           4855
   Ambulatory Surgical Service                               0034
   Referred Ambulatory Service                               0028
   Renal Dialysis                                            0383
Description                                                 Class Code
   Methadone Maintenance Treatment Program                    0119
   Women and Infant Children Program (WIC)                    4847
   Emergency Service                                          0027
   CPEP                                                       0385
   Poison Control                                             4845
   Observation Beds (Non-Distinct Part)                       0030
   Observation Beds (Distinct Part)                           4846
   CPEP Observation Beds (Psychiatric)                        0096
   Other Outpatient Cost Centers                            4856-4902
   Federally Qualified Health Center (FQHC)                   4903
Other Reimbursable Cost Center Line Assignments (50)
   Home Program Dialysis                                      0020
   Ambulance Services                                         0031
   HHA - Administrative & General                             0113
   HHA - Skilled Nursing Care                                 0381
   HHA - Physical Therapy                                     0134
   HHA - Occupational Therapy                                 0135
   HHA - Speech Pathology                                     0136
   HHA - Medical Social Services                              0382
   Home Health Aide                                           0029
   Other HHA Services                                         0021
   Additional Other Reimbursable Cost Centers          3212-3236, 4916-4922
Special Purpose Cost Center Line Assignments (50)
   Lung Acquisition                                           3302
   Kidney Acquisition                                         0101
   Liver Acquisition                                          0138
   Heart Acquisition                                          0392
   Pancreas Acquisition                                       3303
   Intestinal Acquisition                                     3304
   Islet Cell Acquisition                                     3305
   Other Organ Acquisition (specify)                          0390
   Ambulatory Surgical Center (Distinct Part)                 0128
   Hospice Inpatient                                          0391
   Additional Special Purpose Cost Centers                  3306-3341

				
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