Facility Fee Reporting

Hospital Facility Fees

In accordance with RCW 70.01.040, all hospitals with off-campus provider-based clinics that bill a separate facility fee shall report information annually to the Department of Health. The reports are collected at the end of the fiscal year.

202220212020 | 2019 | 2018

Forms

Hospitals shall submit the number of off-campus provider-based clinics owned or operated by the hospital that charge or bill a separate facility fee; the number of patient visits at each off-campus, provider-based clinic for which a facility fee was charged or billed for the year; the revenue received by the hospital for the year by means of facility fees at each off-campus, provider-based clinic; and the range of allowable facility fees paid by public or private payers at each off-campus, provider-based clinic using DOH Form 346-094 Hospital Owned Provider-Based Clinic Facility Fee Reporting (Excel).

Completed forms should be submitted to us via email or via managed file transfer (MFT).

Due dates

Report the data along with the year-end financial reports submitted to the Department of Health pursuant to RCW 43.70.052. This reporting date is 120 days after the end of the hospital's fiscal year.