Clinical Mission

Sales and Services Revenue:

Sales and Service associated with Affiliated Hospitals should use a Budget/Subclass of 71.  All other Sales and Services Revenue should remain on 72.

Affiliated Hospitals include any hospital that we currently do have a profit sharing arrangement. Our current list includes:

  • Barnes Jewish Hospital
  • St. Louis Children’s Hospital
  • Barnes Jewish West County Hospital
  • Orthopedic Center in Chesterfield
  • Children’s Specialty Care Center Chesterfield
  • Siteman Cancer Center South County (formerly referred to as Phase I)
  • Center for Advanced Medicine South County (formerly referred to as Phase II)

Example: Budget/Subclass Object of 71-95

Clinical Practice: Patient care services to individual patients normally eligible to be billed to Medicare, commercial insurance or the patient. Represents the “fee for service” generating activity — time spent on activities that focus on directly identifiable patient care services for which a professional fee to a patient can be generated. Includes:

  • Inpatient, outpatient, procedural, surgical, laboratory-based, or outreach activity for which a bill could be generated for Medicare Part B or covered under commercial insurance as physician services.
  • Follow-up and documentation time required supporting direct patient care.
  • Training or professional development activities which are intended to improve clinical skills
  • Clinical marketing activities
  • Patient care services performed by fellows that are not in an ACGME accredited program
  • Support staff and personnel performing clinical administrative functions. These include:
    • Billing
    • Collections
    • Labs used specifically for patient care
    • Scheduling/Registration
    • Other Administrative Activities

Excludes:

  • Time instructing residents or fellows in an ACGME accredited program
  • Activities associated with the management of hospital services or administration of hospital activities
  • Patient care activities which are associated with research projects
  • Credentialing and Enrollment staff

Payroll Object Code

FIS A-21 Category Code
(424 Code)
FIS Function Code
(450 Code)

Space Indirect Cost
(IDC) Code

15

01 15

95

Graduate Medical Education:  Supervision/instruction of persons enrolled in accredited ACGME intern, residency and fellow programs, direction/coordination of ACGME programs as well as patient care effort of ACGME fellows/residents. Includes:

  • Residency/Fellowship Directors, program coordinators’ time overseeing, managing and administering the program.
  • Other support activities associated with the program such as recruiting and scheduling rotations.
  • Additional time spent delivering patient care due to the presence and supervision of residents.
  • Teaching clinical procedures and preparing for and leading grand rounds.
  • ACGME fellows performing patient care.

Hospitals with Object Code:

  • Barnes Jewish Hospital (16)
  • St. Louis Children’s Hospital (19)
  • Barnes Jewish West County Hospital (18)
  • Orthopedic Center in Chesterfield (18)
  • Children’s Specialty Care Center Chesterfield (19)
  • Siteman Cancer Center South County (formerly referred to as Phase I) (18)
  • Center for Advanced Medicine South County (formerly referred to as Phase II) (18)

Non-Affiliated Hospitals (17)

  • General Guidance: Adhere to the ACGME requirements

Excludes:

  • Time instructing residents or fellows in a non ACGME accredited program (see 13-Instruction).
  • Patient care services performed by fellows that are not in an ACGME accredited program (see 15-Patient Care).

Payroll Object Code

FIS A-21 Category Code
(424 Code)
FIS Function Code
(450 Code)
Space Indirect Cost
(IDC) Code
16,17,18,19 01 18

95

Affiliated Services:  Includes all services, general clinical support activities and contractual agreements that benefit the defined Affiliated Hospitals listed below, and do not generate an RVU or fee for service revenue for WUSM.  Examples include:

  • General oversight of clinical activities in the hospitals and hospital-based clinics
  • Service on Hospital Committees (including administrative and leadership committees)
  • Administrative and general patient care services (reimbursable as Medicare Part A services)
  • Patient safety and quality assurance activities
  • Staff/Physician credentialing
  • Contracts for specific medical direction services and/or clinical mission support agreements
  • Medical management of hospital based clinical service lines programs such as anesthesiology, radiology, emergency medicine, infection control, and laboratory/pathology.

Affiliated Hospitals include any hospital that we currently do have a profit sharing arrangement. Our current list includes:

Object Code:

  • Barnes Jewish Hospital (56)
  • St. Louis Children’s Hospital (59)
  • Barnes Jewish West County Hospital (58)
  • Orthopedic Center in Chesterfield (58)
  • Children’s Specialty Care Center Chesterfield (59)
  • Siteman Cancer Center South County (formerly referred to as Phase I) (58)
  • Center for Advanced Medicine South County (formerly referred to as Phase II) (58)

Excludes:

  • Supervision of residents, Contracts with MO Baptist and Shriners

Payroll Object Code

FIS A-21 Category Code
(424 Code)
FIS Function Code
(450 Code)
Space Indirect Cost
(IDC) Code
56, 58, 59 01 58

95

Non-Affiliated Services: Includes all services, general clinical support activities and contractual agreements that benefit a non-Affiliated Hospital defined below, and do not generate an RVU or fee for service revenue for WUSM. Agreements can include “Flat Fee” or Bundled Payment contracts where there is direct patient care and no WUSM RVU’s or fee for service revenues generated.  Examples include:

  • General oversight of clinical activities in the hospitals and hospital-based clinics
  • Service on Hospital Committees (including administrative and leadership committees)
  • Administrative and general patient care services (reimbursable as Medicare Part A services)
  • Patient safety and quality assurance activities
  • Staff/Physician credentialing
  • Contracts for specific medical direction services and/or clinical mission support agreements
  • Medical management of hospital based clinical service lines programs such as anesthesiology, radiology, emergency medicine, infection control, and laboratory/pathology.
  • Non-Affiliated Hospitals include any hospital that we currently do not have a profit sharing arrangement.  Current examples include MO Baptist and Shriners.

Excludes:

  • Supervision of residents, Contracts with Affiliated Hospitals

Payroll Object Code

FIS A-21 Category Code
(424 Code)
FIS Function Code
(450 Code)
Space Indirect Cost
(IDC) Code
57 01 57

95