,,3895 (Cont.),,,FORM CMS-1984-99,,,,09-11,
,,,           ELECTRONIC REPORTING SPECIFICATIONS FOR FORM CMS 1984-99,,,,,,,
,,,                TABLE 5 - STANDARD COST CENTER DESCRIPTIONS AND CODES,,,,,,,
,,,,,,,,,,
,,,,CODE,USE,,,CODE,USE,
,,,,,,,,,,
,,     GENERAL SERVICE COST CENTERS,,,,,     OTHER HOSPICE SERVICE COST CENTERS,,,
,,,,,,,,,,
,,Capital Rel Costs-Bldg & Fixt,,0100,(50),,"Drugs, Biological and Infusion ",3000,(30),
,,,,,,,Analgesics,3030,(1),
,,,,,,,Sedatives/Hypnotics,3031,(1),
,,Capital Rel Costs-Movable Equip,,0200,(50),,Durable Medical Equipment/Oxygen,3100,(30),
,,Plant Operation and Maintenance,,0300,(50),,Patient Transportation,3200,(30),
,,Transportation-Staff,,0400,(50),,Imaging Services,3300,(30),
,,Volunteer Service Coordination,,0500,(20),,Labs. And Diagnostics,3400,(30),
,,Administrative and General,,0600,(20),,Med Supplies Charged to Patients,3500,(30),
,,,,,,,Outpatient Services (incl E/R Dept.),3600,(30),
,,     INPATIENT CARE SERVICE ,,,,,Radiation Therapy,3700,(30),
,,,,,,,Chemotherapy,3800,(30),
,,Inpatient-General Care,,1000,(20),,,,,
,,Inpatient-Respite Care,,1100,(20),,,,,
,,,,,,,     HOSPICE NONREIMBURSABLE COST CENTERS,,,
,,     VISITING SERVICES ,,,,,,,,
,,,,,,,Bereavement Program Costs,5000,(20),
,,Physician Services,,1500,(20),,Volunteer Program Costs,5100,(20),
,,Nursing Care,,1600,(20),,Fundraising,5200,(20),
,,Nursing Care-Continuous Home Care,,1620,(20),,,,,
,,Physical Therapy,,1700,(20),,,,,
,,Occupational Therapy,,1800,(20),,,,,
,,Speech/language Pathology,,1900,(20),,,,,
,,Medical Social Services,,2000,(20),,,,,
,,Spiritual Counseling,,2100,(20),,,,,
,,Dietary Counseling,,2200,(20),,,,,
,,Counseling-Other,,2300,(20),,,,,
,,Home Health Aide and Homemaker,,2400,(20),,,,,
,,HH Aide and Homemaker-Cont Home Care,,2420,(20),,,,,
,,,,,,,,,,
,,                                                 ,,,,,,,,
,,,,,,,,,,
,,,           TABLE 5 - NONSTANDARD COST CENTER DESCRIPTIONS AND CODES,,,,,,,
,,,,,,,,,,
,,     GENERAL SERVICE COST CENTERS,,,,,,,,
,,,,,,,,,,
,,A&G-Shared Costs,,0621,(01),,,,,
,,A&G-Reimbursable Costs,,0622,(01),,,,,
,,A&G-Nonreimbursable Costs,,0623,(01),,,,,
,,,,,,,,,,
,,,,,,,,,,
,,,,,,,,,,
,,     VISITING SERVICES ,,,,,,,,
,,,,,,,,,,
,,Other Visiting Services,,2500,(50),,,,,
,,,,,,,,,,
,,     OTHER HOSPICE SERVICE COST CENTERS,,,,,,,,
,,,,,,,,,,
,,Other Hospice Service Cost Center,,3900,(50),,,,,
,,Other-Specify,,3032,(30),,,,,
,,,,,,,,,,
,,     NONREIMBURSABLE COST CENTERS,,,,,,,,
,,,,,,,,,,
,,Other Nonreimbursable Costs,,5300,(50),,,,,
,,,,,,,,,,
,,,,,,,,,,
,,,,,,,,,,
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,,,,,,,,,,
,,,,,,,,,,
,,,,,,,,,,
,,38-222,,,,,,,Rev. 9,