Bethany Children’s Health Center Consumer Price Transparency
Updated 1/1/2023
| Level of Services | Standard Hospital Charge | Private Pay Patients | De-identified Minimum Negotiated Charge | De-identified Maximum Negotiated Charge | Aetna | Blue Cross and Blue Shield of Oklahoma | Cigna | Healthcare Highways | Healthchoice | United Health Care |
|---|---|---|---|---|---|---|---|---|---|---|
| Long-term Acute Care Hospital (LTAC) Services | $2,474 | $2,474 | $1,000 | $1,843 | $1,190 | $1,284 | $1,000 | $1,500 | $1,575 | $1,843 |
| Inpatient Rehabilitation Services | $2,321 | $2,321 | $1,070 | $1,575 | $1,500 | $1,070 | $1,200 | $1,450 | $1,575 | $1,450 |
| Medical/Surgical Services | $1,864 | $1,864 | $1,100 | $1,575 | $1,190 | * N/A | * N/A | $1,100 | $1,575 | $1,450 |
| Subacute Care/Skilled Nursing Services | $1,775 | $1,775 | $749 | $1,575 | $951 | $749 | $900 | $1,050 | $1,575 | $1,086 |
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 1/1/2023
Office Visits
| Procedure Code | Code Description | Fee Schedule |
|---|---|---|
| 99202 | New patient straightforward medical decision making | $ 80.49 |
| 99203 | New patient low level of medical decision making | $124.43 |
| 99204 | New patient moderate level of medical decision making | $186.41 |
| 99205 | New patient high level of medical decision making | $246.81 |
| 99212 | Established patient straightforward medical decision making | $62.33 |
| 99213 | Established patient low level of medical decision making | $100.78 |
| 99214 | Established patient moderate level of medical decision making | $142.59 |
| 99215 | Established patient high level of medical decision making | $201.41 |
| 99381 | New patient preventative medicine, infant less than 1 year old | $121.33 |
| 99382 | New patient preventative medicine, age 1 through 4 years | $126.76 |
| 99383 | New patient preventative medicine, age 5 through 11 years | $131.89 |
| 99384 | New patient preventative medicine, age 12 though 17 years | $150.23 |
| 99391 | Established patient preventative medicine, infant less than 1 year old | $109.64 |
| 99392 | Established patient preventative medicine, age 1 through 4 years | $116.69 |
| 99393 | Established patient preventative medicine, age 5 through 11 years | $116.34 |
| 99394 | Established patient preventative medicine, age 12 through 17 years | $127.60 |
Speech Therapy/Physical Therapy/Occupational Therapy
| Procedure Code | Code Description | Fee Schedule |
|---|---|---|
| 92507 | Treatment of speech, language, voice, communication and/or auditory processing disorder | $86.71 |
| 92523 | Evaluation of speech sound production with evaluation of language comprehension and expression | $256.74 |
| 92526 | Treatment of swallowing dysfunction and/or oral function for feeding | $95.83 |
| 92610 | Evaluation of oral and pharyngeal swallowing function | $95.90 |
| 97110 | Therapeutic procedure to develop strength and endurance, range of motion and flexibility (each 15 minutes) | $33.14 |
| 97112 | Therapeutic procedure neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities (each 15 minutes) | $38.38 |
| 97116 | Therapeutic procedure gait training (each 15 minutes) | $33.14 |
| 97161 | Physical therapy evaluation: low complexity | $112.76 |
| 97162 | Physical therapy evaluation: moderate complexity | $112.76 |
| 97163 | Physical therapy evaluation: high complexity | $112.76 |
| 97165 | Occupational therapy evaluation: low complexity | $113.48 |
| 97166 | Occupational therapy evaluation: moderate complexity | $113.48 |
| 97167 | Occupational therapy evaluation: high complexity | $113.48 |
| 97530 | Therapeutic activities, direct patient contact | $41.29 |
| 97533 | Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands (each 15 minutes) | $70.39 |
| 97535 | Self-care/home management training (each 15 minutes) | $36.70 |