Program Pricing

Bethany Children’s Health Center Consumer Price Transparency
Updated 12/31/2021

Level of ServicesStandard Hospital ChargePrivate Pay PatientsDe-identified Minimum Negotiated ChargeDe-identified Maximum Negotiated ChargeAetnaBlue Cross and Blue Shield of OklahomaCignaHealthcare HighwaysUnited Health Care
Long-term Acute Care Hospital (LTAC) Services$2,291$2,291$1,000$1,772$1,190$1,284$1,000$1,500$1,772
Inpatient Rehabilitation Services$2,149$2,149$1,070$1,500$1,500$1,070$1,200$1,450$1,394
Medical/Surgical Services$1,718$1,718$1,100$1,394$1,190* N/A* N/A$1,100$1,394
Subacute Care/Skilled Nursing Services$1,470$1,470$749$1,050$951$749$900$1,050$1,044

Bethany Children’s Health Center charges all patients and payers on a per diem basis. The per diem charge is inclusive of all services, including professional and ancillary services, provided during an inpatient stay. There are four levels of service that are provided to our patients. The level of service is determined by the medical criteria of the payer, based on established clinical guidelines, and based on Bethany Children’s Health Center’s clinical assessment of our patients.

Services are billed and reimbursed primarily based on Revenue Code. However, a Revenue Code can apply across multiple levels of services provided. Arrangements are made with each specific payer as to the recognized Revenue Code for reimbursement purposes.

All private pay billing is at the Standard Hospital Charge. Bethany Children’s does not have a set Discounted Cash Price that is offered to self-pay patients. On a case-by-case basis, Bethany Children’s works with individual patients to determine expected payment.

Note: Payers are not contracted for all levels of care. In that case, “N/A” for Not Applicable is indicated.

Bethany Children’s Health Center Outpatient Program Pricing
Updated 1/25/2022

Office Visits

Procedure CodeCode DescriptionFee Schedule
99202New patient straightforward medical decision making$ 80.43
99203New patient low level of medical decision making$124.46
99204New patient moderate level of medical decision making$186.93
99205New patient high level of medical decision making$247.10
99212Established patient straightforward medical decision making$61.85
99213Established patient low level of medical decision making$101.25
99214Established patient moderate level of medical decision making$144.04
99215Established patient high level of medical decision making$201.65
99381New patient preventative medicine, infant less than 1 year old$122.61
99382New patient preventative medicine, age 1 through 4 years$128.14
99383New patient preventative medicine, age 5 through 11 years$133.26
99384New patient preventative medicine, age 12 though 17 years$150.11
99391Established patient preventative medicine, infant less than 1 year old$110.19
99392Established patient preventative medicine, age 1 through 4 years$117.94
99393Established patient preventative medicine, age 5 through 11 years$117.58
99394Established patient preventative medicine, age 12 through 17 years$128.94

Speech Therapy/Physical Therapy/Occupational Therapy

Procedure CodeCode DescriptionFee Schedule
92507Treatment of speech, language, voice, communication and/or auditory processing disorder$86.71
92523Evaluation of speech sound production with evaluation of language comprehension and expression$260.55
92526Treatment of swallowing dysfunction and/or oral function for feeding$95.54
92610Evaluation of oral and pharyngeal swallowing function$95.34
97110Therapeutic procedure to develop strength and endurance, range of motion and flexibility (each 15 minutes)$33.41
97112Therapeutic procedure neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities (each 15 minutes)$38.69
97116Therapeutic procedure gait training (each 15 minutes)$33.41
97161Physical therapy evaluation: low complexity$112.34
97162Physical therapy evaluation: moderate complexity$112.34
97163Physical therapy evaluation: high complexity$112.34
97165Occupational therapy evaluation: low complexity$109.10
97166Occupational therapy evaluation: moderate complexity$109.10
97167Occupational therapy evaluation: high complexity$109.10
97530Therapeutic activities, direct patient contact$42.71
97533Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands (each 15 minutes)$64.85
97535Self-care/home management training (each 15 minutes)$37.00