Glossary

A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.

Factors other than price, including volume of services, intensity of services, and age/sex changes.

A scale of national uniform relative values for all physicians' services. The relative value of each service must be the sum of relative value units representing physicians' work, practice expenses net of malpractice expenses, and the cost of professional liability insurance.

Temporary or periodic care provided in a nursing home, assisted living residence, or other type of long-term care program so that the usual caregiver can rest or take some time off.

Physical restraints are any manual method or physical or mechanical device, material, or equipment attached to or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to ones body. Chemical restraints are any drug used for discipline or convenience and not required to treat medical symptoms.

Reuse of CMS data occurs when a requestor, from the same or different organization requests permission to use CMS data already obtained for a prior approved project.

The recognition of income earned and the use of appropriated capital from the rendering of services in the current period.

Payment codes for services or items in FL 42 of the UB-92 found in Medicare and/or NUBC (National Uniform Billing Committee) manuals (42X, 43X, etc.)

Using information on a claim or other information requested to support the services billed, to make a determination.

• Receive notice of information practices;
• See and copy own records;
• Request corrections; Obtain accounting of disclosures;
• Request restrictions and confidential communications;
• File complaints