$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Wednesday, 12/31/25 at 10:37 ============================================================================= Run Date: FEB 19, 2026 Designation: IB*2*843 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #767 Status: Released Compliance Date: FEB 26, 2026 ============================================================================= Associated patches: (v)IB*2*835 <<= must be installed BEFORE `IB*2*843' Subject: REASONABLE CHARGES V5.26 CY26 UPDATE Category: - Routine - Other Description: ============ ************************************************************************** NOTE: This patch is being released with a shortened compliance date of 7 days. ************************************************************************** Implementation of Reasonable Charges v5.26 is a two-step process: 1. Installation of this patch. This will inactivate Reasonable Charges v5.251 charges with an inactive date of 12/31/25. (See Installation Instructions.) 2. Uploading the Reasonable Charges v5.26 charges. This will load new charges with an effective date of 01/01/26 and needs to be done immediately after the patch install. (See Upload Instructions.) PLEASE NOTE: It is highly recommended that you install the Lexicon Utility patch LEX*2.0*157 - CODE SET FY26 2ND QTR UPDATE before IB*2.0*843 install. Failure to install this patch may require uploading and installing Reasonable Charges twice. ************************************************************************** Reasonable Charges version 5.26 is a charge update to the existing Reasonable Charges billed to Third Party Payers. The primary update with this patch is to the charges, which will be implemented when the new RC v5.26 charges are uploaded (step 2 in Installation Overview). This version of Reasonable Charges implements the following charge changes: Effective Date of Reasonable Charges v5.26 is 01/01/26. Inactive Date of Reasonable Charges v5.251 is 12/31/25. Reasonable Charges v5.251 loaded on your system will be inactivated with an inactivation date of 12/31/25 when this patch is installed. Reasonable Charges v5.26 with an effective date of 01/01/26 will be loaded on your system when the charges are uploaded as described below. EHRM Impact Statement: ---------------------- This patch should have no EHRM impact, and can be installed at all sites, including EHRM converted sites. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Coordination: N/A New Service Requests (NSRs): N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC40939334: Initiate IB Outpatient/Inpatient Patch V5.26 for CY26 in VistA with an Effective Date of 01/01/26 Problem: -------- Changes in the national Diagnosis Related Group (DRG) rates need to be distributed to all hospitals so that proper billing can take place. Resolution ----------- This patch updates the Reasonable Charges files and distributes them with a new version number and a new effective date. Routines: IBCRHBRV, IBYP843 Technical Description ===================== This patch exports 2 routines, one of which is the post-init (IBYP843) The post-init routine will inactivate all existing Reasonable Charges defined in the Charge Master. Reasonable Charges v5.251 will be inactivated with an inactivation date of 12/31/25 when the patch is installed. The following is an example of the post-init portion of the installation: Running Post-Install Routine: POST^IBYP843 Reasonable Charges v5.26 Post-Install ..... >> Inactivating Existing Reasonable Charges, Please Wait... Done. 79084 existing charges inactivated Reasonable Charges v5.26 Post-Install Complete Note: The actual number of charges inactivated and facility type of billing regions changed will vary based on the number of divisions billed at your site. This will also determine the time required for the installation. Test Sites: ----------- VA Connecticut Health Care System (West Haven, Newington),CT NorthPort VA Medical Center, NY SNOW Change Order #: -------------------------------- Connecticut - CHG0684124 Northport - CHG0684121 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. This release also includes other software files. Sites may retrieve the charge files using Secure File Transfer Protocol (SFTP) in ASCII format at the location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE. Other Software Files: File Title File Name Format --------------------------------------------------------------------- Inpatient Facility Charges (DRG) IBRC2601A.TXT ASCII Outpatient Facility Charge (CPT) IBRC2601B.TXT ASCII Physician Charges (CPT) IBRC2601C.TXT ASCII Service Category Codes IBRC2601D.TXT ASCII Area Factors IBRC2601E.TXT ASCII Site Identification IBRC2601F.TXT ASCII Patch Installation: Pre/Post Installation Overview: ------------------------------- 1. Installation of this patch will inactivate Reasonable Charges v5.251 charges with an inactive date of 12/31/25. (See Installation Instructions.) 2. Uploading the Reasonable Charges v5.26 charges. This will load new charges with an effective date of 01/01/26 and needs to be done immediately after the patch install. (See Upload Instructions.) (1) Pre-Installation Instructions: ---------------------------------- If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file be disabled to prevent possible conflicts while running the KIDS Install. Other Vista users will not be affected. Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Install Time - less than 30 minutes - but will vary from site to site depending on the size of the CHARGE ITEM (#363.2) file which is searched for charges to inactivate in the post-init routine. Loading the Charge Master with the new RC v5.26 charges is separate from the patch installation and will take additional time per division. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name IB*2.0*843. B. Select the Backup a Transport Global option to create a backup message of any routines exported with this patch. For each patch you can specify what to backup; the entire Build or just Routines. When asked to specify what to backup, select Routines. When prompted for a response, select Routines: Select one of the following: B Build R Routines Enter response: Build C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install, IB*2.0*843. i. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO ii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer YES a. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following option: Option Name Menu Text ----------- --------- Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Press the Enter key when you are done selecting options. b. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . c. When prompted 'Delay Install (Minutes): (0 - 60): 0//', answer 0. Post-Installation Instructions: (2) UPLOAD REASONABLE CHARGES V5.26 ------------------------------------ Follow instructions below: RC v5.26 Upload Instructions ********************** RC v5.26 Upload Instructions ******************** After patch installation, the Reasonable Charges v5.26 charges will need to be loaded into the Charge Master for each division billed at the site. The charges for each Division will require approximately 1.8 - 2.0 MB of disk space. Other files will be searched, but the new charges will be added to the CHARGE ITEM file (#363.2). *** PLEASE NOTE *** Sites may see this error when uploading the reasonable charges. This error can be ignored (2 with $=0). If your site receives an error for two records, CPT 90611 and 90622, in which the charge is $0.00, this is acceptable to allow. The national charge for these codes is $.01 as the vaccines are provided to VA by the government and we do not bill third party payers, however we need a charge present to bill for the associated administration charge. If these vaccines are given to patients with billable insurance in any of the 15 zip codes that have a geographic adjustment factor of less than .5 resulting in the $.01 to be rounded down to $.00, billing staff will reach out to the Rates and Charges Team for guidance at that time. It is appropriate to accept the error if the results show two charges with $=0. SNF Fac 1 8394 of 8394 records checked, 0 duplicates, 2 with $=0 0 line/data errors or warnings found for a 0% error rate. 8392 entries added to the Charge Set RC-SNF FAC PR XXXXX. Opt Fac 1 9123 of 9123 records checked, 0 duplicates, 2 with $=0 0 line/data errors or warnings found for a 0% error rate. 9121 entries added to the Charge Set RC-OPT FAC PR XXXXX. Files Required for Upload: -------------------------- Sites may retrieve the charge files using Secure File Transfer Protocol (SFTP) in ASCII format at the location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE. The Reasonable Charge v5.26 Host Files, effective 01/01/26: (ASCII) IBRC2601A.TXT Inpatient Facility Charges (DRG) IBRC2601B.TXT Outpatient Facility Charges(CPT) IBRC2601C.TXT Physician Charges (CPT) IBRC2601D.TXT Service Category Codes IBRC2601E.TXT Area Factors IBRC2601F.TXT Site Identification Upload Instructions: ==================== Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v5.26 Host Files in ASCII format (see previous section). Step 2: Determine Divisions ---------------------------- Use the Print Charge Master [IBCR REPORTS FOR CHARGE MASTER] option and print the Billing Regions report to find which Billing Regions and Divisions have charges loaded onto your system. These are the divisions that will need new charges loaded. Step 3: Begin Upload Process ----------------------------- Use the Load Host File into Charge Master [IBCR HOST FILE LOAD] option to load Reasonable Charges onto your system for every division for which care is billed at your site. Carefully follow the instructions below, for each Billing Region. You will see the prompt: Select one of the following: 1.1 Load CMAC into XTMP 1.2 Load AWP into XTMP 1.3 Load RC into XTMP 1.4 Load TP into XTMP 2 Assign Charge Set 3 Check Data Validity 4 Load into Charge Master 5 Delete XTMP files Below, in more detail, the steps will guide you through the process of selecting first 1.3, then 3, then 4, and wait until 4 stops before continuing on to the next division (and capturing or printing all output for future reference). Step 4: Load the Reasonable Charges ------------------------------------ From the menu, select option 1.3 - Load RC into XTMP This loads the Host Files into temporary storage and calculates charges for individual Divisions. - If there are no previously existing host files loaded, it will ask which version of Reasonable Charges to load. Select 5.26 - When loading Reasonable Charges v5.26 the IBRC2601x.TXT files may be used for multiple divisions without reloading. - If there exists any previously calculated charges (files) for a division, they will be displayed, and you will get the prompt: The above files already exist in XTMP. Delete the above files and continue with upload? Select Yes, to delete the previously calculated charges. - If there exist any previously loaded host files for any RC version, they will be displayed, and it will ask if they should be deleted. Select No, if the files are IBRC2601x.TXT since these are the correct files for v5.26, they may be re-used for multiple divisions. Select Yes only if the files are from a different version. - Select Division: Select the division number to load charges for. This should correspond to the Divisions associated with the Billing Regions determined previously. Once the correct division is selected, answer Yes to Calculate Charges. Step 5: Check Data Validity --------------------------- From the menu, select option 3 - Check Data Validity This is optional, but it is suggested that it be run at least once, for the first division loaded. If the resulting report has any Line Data Errors, then check that the latest version of CPT and DRG has been installed. The Error key at the end of the report does not mean that errors have occurred. It simply provides definitions of the types of errors that might occur. Check the individual line items in the report to see if any of the listed errors have been detected. Step 6: Load into Charge Master ------------------------------- From the menu, select option 4 - Load into Charge Master Moves the charges calculated in selection 1.3 to permanent storage in the Charge Master. The results report should match the examples below. It is important that this option completes before continuing. Allow the upload of a division's charges to finish before attempting to upload another division. A summary report will be printed when the upload is complete. This option uses the same temporary files to calculate the charges for all divisions, therefore they must be calculated and loaded serially. Step 7: Repeat steps 4-6 for each Division needed ------------------------------------------------- Steps 4-6 must be repeated for each division billed at your site. Refer to the Divisions that already have charges assigned using the Billing Region Report list determined previously. In most cases, simply using the above options for loading Reasonable Charges will result in the correct set up in the Charge Master. - Option 1.3, to calculate charges for a division - Option 4, to load those calculated charges into the Charge Master permanent files. However, if you are loading charges for a new site, or a site that may have changed its division number, then extra care is needed to ensure the setup of the Charge Master is correct. The following sections provide examples of displays and reports for the upload. ================= Reasonable Charges v5.26 Upload Details ============== The Charge Host Files should load with the following counts: The following files were created in XTMP, they will be purged in 2 days: ------------------------------------------------------------------------ IBRC2601A.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONN 771 IBRC2601B.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONN 9132 IBRC2601C.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONN 18181 IBRC2601D.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONN 30 IBRC2601E.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONN 917 IBRC2601F.TXT RC v5.26 Host File Upload, 1/29/26@18:49 by ROWE,DONNA 1563 Any division that provides Inpatient Care should result in a summary with the following counts: IBCR UPLOAD RC 402 TOGUS VA MEDICAL CENTER, ME Count = 58714 IB Upload RC v5.26 402 TOGUS VA MEDICAL CENTER, ME, 1/29/26@18:50 by ROWE,D ONNA M Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 80 RC-INPT FAC PR 402 2 Inpt Fac 2 CPT 3 RC-INPT FAC HR 402 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 402 4 Inpt Fac/Phys 1 CPT 2931 RC-INPT FAC PR 402 5 Inpt PD Anc DRG 770 RC-INPT ANC 402 6 Inpt PD Anc ICU DRG 770 RC-INPT ANC ICU 402 7 Inpt PD R&B DRG 770 RC-INPT R&B 402 8 Inpt PD R&B ICU DRG 770 RC-INPT R&B ICU 402 9 Inpt Phys 1 CPT 8733 RC-PHYSICIAN INPT PR 402 10 Inpt Phys 3 CPT 275 RC-PHYSICIAN INPT MN 402 11 Opt Fac 1 CPT 9123 RC-OPT FAC PR 402 12 Opt Fac 2 CPT 3 RC-OPT FAC HR 402 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 402 14 Opt Fac/Phys 1 CPT 5602 RC-OPT FAC PR 402 15 Opt PD PHosp MISCE 1 RC-OPT MISC 402 16 Opt Phys 1 CPT 7383 RC-PHYSICIAN OPT PR 402 17 Opt Phys 3 CPT 239 RC-PHYSICIAN OPT MN 402 18 SNF Fac 1 CPT 8394 RC-SNF FAC PR 402 19 SNF Fac 2 CPT 3 RC-SNF FAC HR 402 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 402 21 SNF Fac/Phys 1 CPT 3823 RC-SNF FAC PR 402 22 SNF PD INC BEDSE 2 RC-SNF INC 402 23 SNF Phys 1 CPT 8749 RC-PHYSICIAN SNF PR 402 24 SNF Phys 3 CPT 275 RC-PHYSICIAN SNF MN 402 IB Upload Data Validity Check on Temporary files 1/29/ 26@18:51:19 Page 1 -------------------------------------------------------------------------- ------ ------------------- IBCR UPLOAD RC 402 TOGUS VA MEDICAL CENTER, ME Inpt Fac 1 80 of 80 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Fac/Phys 1 2931 of 2931 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc 770 of 770 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD Anc ICU 770 of 770 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B 770 of 770 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt PD R&B ICU 770 of 770 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 1 8733 of 8733 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Inpt Phys 3 275 of 275 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 1 9123 of 9123 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac/Phys 1 5602 of 5602 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 1 7383 of 7383 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 239 of 239 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 1 8394 of 8394 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Fac/Phys 1 3823 of 3823 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF PD INC 2 of 2 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Phys 1 8749 of 8749 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. SNF Phys 3 275 of 275 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Any provider-based division that provides Outpatient Care only should result in a summary with the following counts: IBCR UPLOAD RC 402GA PRESQUE ISLE VA CLINIC, ME Count = 22356 IB Upload RC v5.26 402GA PRESQUE ISLE VA CLINIC, ME, 1/29/26@18:55 by ROWE, DONNA M Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 9123 RC-OPT FAC PR 402GA 2 Opt Fac 2 CPT 3 RC-OPT FAC HR 402GA 3 Opt Fac 4 CPT 5 RC-OPT FAC ML 402GA 4 Opt Fac/Phys 1 CPT 5602 RC-OPT FAC PR 402GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 402GA 6 Opt Phys 1 CPT 7383 RC-PHYSICIAN OPT PR 402GA 7 Opt Phys 3 CPT 239 RC-PHYSICIAN OPT MN 402GA IB Upload Data Validity Check on Temporary files 1/29/ 26@18:56:19 Page 1 -------------------------------------------------------------------------- ------ ------------------- IBCR UPLOAD RC 402GA PRESQUE ISLE VA CLINIC, ME Opt Fac 1 9123 of 9123 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 2 3 of 3 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Fac/Phys 1 5602 of 5602 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 1 7383 of 7383 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Opt Phys 3 239 of 239 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. Optional - Once this patch has been successfully installed you may delete the post init routines: IBYP843. Back-Out/Roll Back Plan: ------------------------ Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. In the event that the patch installer decides to back out this patch, the patch installer should log a Service Now ticket or contact the Enterprise Service Desk (ESD) at 855-673-4357. Backout or rollback of the software will be a joint decision between the development team, VA site/region personnel and other appropriate VA personnel and will require their concurrence. The development team will need to issue a follow-on patch in order to comprehensively back-out this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 6 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCRHBRV Before: B58168913 After: B58598886 **148,169,245,270,285,298,325, 334,355,360,365,382,390,408, 412,423,427,439,445,462,468, 484,491,508,520,536,542,556, 559,573,584,600,612,628,634, 658,667,683,693,719,724,744, 755,783,809,814,835,843** Routine Name: IBYP843 Before: n/a After: B6093806 **835** Routine list of preceding patches: 835 ============================================================================= User Information: Entered By : Date Entered : DEC 03, 2025 Completed By: Date Completed: FEB 19, 2026 Released By : Date Released : FEB 19, 2026 ============================================================================= Packman Mail Message: ===================== $END TXT