Patient Administration - Army Publishing Directorate - U.S. Army

(a) Postoperative treatment.
(b) Occlusal adjustments.
(c) Denture adjustments.
(d) Tissue conditioning treatments.
(e) Treatments following surgical, periodontal, and endodontic procedures to promote healing or to verify recovery.
(4) If a patient visits both a medical clinic and the dental clinic on the same day, two outpatient visit charges will
apply unless—
(a) The visit to the medical clinic qualifies as a nonchargeable visit under b above.
(b) The visit to the dental clinic was medically directed by the attending physician for dental care adjunctive to the
medical treatment.
(5) Although a per case or per shot rate is established for immunizations when given in conjunction with a
chargeable outpatient visit, no extra charge will be made for each shot or dose. Smallpox and other vaccinations,
therapeutic or desensitization (allergy) injections, and TINE tests for tuberculosis are considered immunizations.
(6) Group treatments or evaluations in schools, community centers, isolated locations, or in the MTF are not
chargeable as individual outpatient visits. Group rates, however, will be calculated to cover the actual costs of services
rendered. Such treatments or evaluations include—
(a) School, sports, and other similar examinations.
(b) Group therapy sessions and group activity counseling such as prospective parents’ classes, group instruction in
first aid, and dental or oral hygiene classes.
(7) Services provided under the Occupational Health Services Program for the U.S. employees will be supported
without charge to the individual employee.
(8) Care provided to DOD civilian employees, which is covered under the OWCP, is not charged to the patient.
Non-DOD civilian employees are billed for health care received in MTFs even if it is job related.
(9) Patients admitted and discharged on the same day by an inpatient medical facility will not be charged the
outpatient rate. Rather, they will be charged the appropriate inpatient or ambulatory patient visit rate.
(10) Confidential medical care and advice provided adolescent Family members of Federal civilian employees at
authorized teen clinics and youth health centers will not be chargeable.
(11) Public health measures will not be charged when the area military commanders, upon recommendations of their
principal medical staff officer, determine that such measures are required in the interest of the health of the area. Public
health measures include those services that are recognized and accepted by health authorities as preventing the spread
of communicable, environmental, and industrial diseases, and reducing the common risk to a given disease. Included
are—
(a) Immunizations prescribed by health authorities.
(b) Interview, examination, and follow up of close contacts with tuberculosis, venereal disease, meningococcal
meningitis, viral hepatitis, and other communicable diseases.
(c) Detection and treatment of drug, alcohol, and other substance abuse.
(d) Biological tests associated with epidemiological surveys.
11–15. Chargeable medical examinations and immunizations
The applicable outpatient rate or the immunization rate will be charged for examinations or immunizations furnished
other than in connection with inpatient or outpatient care. (See app B.)
11–16. Use of credit cards for payment
Credit cards may be accepted for payment when the credit card system used does not result in a surcharge to the
Government.
11–17. Billing and reporting procedures
In complying with instructions in this regulation, forward reports of medical service and billing documents to the
authorizing organization. The appropriate address will be used.
11–18. Negotiable instruments
The MSA is responsible for all negotiable instruments received by the activity. All negotiable instruments must be
endorsed, “For deposit to the Treasury of The United States” upon receipt. All negotiable instruments will be deposited
within 24 hours or the next business day in the supporting DAO or a designated Federal repository. Cash on hand will
be deposited daily or on the next business day, whenever possible, to reduce funds held at risk to the holding authority
board.
11–19. Internal controls
The MSA must have in place a system of internal controls to ensure that assets and funds of the Government are not
74 AR 40–400 27 January 2010