26CRY001_-_Bid_Rate_Sheet.xlsm

XLSM spreadsheet 32 KB Posted

Attached to
26CRY0001 - Mobile Radiology and Ultrasound Services
Solicitation number
0000040110
Issued by
California

About this file

This is a bid rate sheet for mobile radiology and ultrasound services submitted to the California Department of Veterans Affairs for contract solicitation 26CRY001 at the Veterans Home of California in Yountville. The sheet establishes the pricing structure for both ultrasound and radiology procedures that bidders must complete and submit as a mandatory attachment. The ultrasound section includes 23 line items covering diagnostic procedures such as thyroid, breast, abdominal, pelvic, vascular doppler, and echocardiography services, with estimated procedure volumes ranging from 2 to 50 procedures over the contract term based on historical usage patterns. The radiology section encompasses 49 line items including skeletal radiography, chest imaging, spine films, and transportation fees for patient movement, with estimated procedure volumes ranging from 1 to 200 procedures based on prior year data. The rate sheet provides Medicare benchmark rates for reference but requires bidders to input their own pricing percentages and total costs in designated yellow cells.

Bidders must establish rates for each procedure line item, with blank submissions understood to indicate services provided at no cost. Rates submitted become binding for the entire contract term and form part of Exhibit B-Budget Detail and Payment Provisions upon award. The state reserves the right to modify the actual volume and scope of services based on resident population fluctuations and operational needs, and makes no guarantee regarding minimum service levels. The grand total of all line items serves as the basis of award and will be used to calculate the lowest responsible bid, with application of small business preferences where applicable. Transportation fees include tiered pricing for moving multiple patients per trip, with additional line items for employee chest X-rays, after-hours fees, and STAT (stat priority) fees per patient visit.

View the file

Other files

Show all 15

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

LAB X-Ray Ultrasound

RATE SHEET

Submission of this attachment is MANDATORY. Upon award, bid below will become part of the Agreement in Exhibit B-Budget Detail and Payment Provisions. The Bidder shall set forth the rates in the yellow spaces provided. Failure to indicate an amount for any item will be understood by the State that the Bidder will provide the item at no cost.

The Basis of Award shall be used to determine the lowest responsible bids.

The State makes no guarantee, expressed or implied, on the actual amount of services that shall be required for this Agreement and is subject to change based on needs of the Home. However, the rates quoted by Bidder shall be binding for the term of the Agreement.

The State does not expressly or by implication agree that the actual amount of work will correspond therewith and reserves the right to omit portions of the work, as may be deemed necessary or advisable, by the State. The sample procedures listed below are some of the procedures utilized in prior years but are not an all inclusive list. The samples will be used to determine a total dollar amount for the Basis of Award to apply to the Small Business Preference when applicable. This is not a guarantee of business, or specific services to be provided, and is subject to change depending on CalVet’s fluctuations in the resident population. Rate of payment will be the rates submitted in yellow spaces below.

ULTRASOUNDSample ProceduresEstimated # of Procedures for the Contract TermAverage Medicare Rate/ Proc.% of MedicareTotal
176536Thyroid10x$ 115.91x=$ - 0
276604US Chest Mediastinum10x$ 61.49x=$ - 0
376641Breast Ultrasound10x$ 108.14x=$ - 0
476700Abdominal Ultrasound10x$ 122.27x=$ - 0
576705Abdomen ITD10x$ 91.88x=$ - 0
676770Retroperitoneal Ultrasound10x$ 114.14x=$ - 0
776856Pelvis Ultrasound10x$ 110.96x=$ - 0
876857Urinary Bladder Ultrasound40x$ 53.01x=$ - 0
976870Scrotum Ultrasound10x$ 105.66x=$ - 0
1093306Echocardio M-Mode 2D10x$ 205.32x=$ - 0
1193880Carotid Artery Profile10x$ 198.60x=$ - 0
1293922Ankle Brachial Index10x$ 86.58x=$ - 0
1393825Lower Bil. Arterial Doppler10x$ 137.47x=$ - 0
1493926Lower Uni. Arterial-right10x$ 150.19x=$ - 0
1593930Upper Bil. Arterial Doppler10x$ 208.50x=$ - 0
1693931Upper Uni. Arterial-Right20x$ 129.34x=$ - 0
1793970Lower Bil. Venous Doppler10x$ 195.42x=$ - 0
1893971Lower Uni. Venous-LT10x$ 125.10x=$ - 0
1993975Flow In/Out Abd. Organs10x$ 275.99x=$ - 0
2093976Flow In/Out Abd. Organs ITD10x$ 167.15x=$ - 0
2193978Duplex Scan Aort./Vena Cav.10x$ 190.12x=$ - 0
2293990Hemodialysis Access10x$ 153.37x=$ - 0
ULTRASOUNDOther ProceduresEstimated #s for the Contract TermRate per ItemTotal
23STAT fee per patient, per visit50x=$ - 0
TOTAL (#1 thru #23)=$ - 0
RADIOLOGYSample ProcedureEstimated # of Procedures for the Contract TermAverage Medicare Rate/ Proc.% of MedicareTotal
170100Mandible35x$ 43.59x=$ - 0
270140Facial Bones < 3 Views35x$ 35.82x=$ - 0
370160Nasal Bones Min. 3 Views35x$ 42.48x=$ - 0
470210Paranasal Sinuses < 3 Views35x$ 36.30x=$ - 0
570250Skull < 4 Views35x$ 40.50x=$ - 0
671045Chest 1 View200x$ 28.91x=$ - 0
771046Chest 2 Views200x$ 37.60x=$ - 0
871100Ribs Unilateral 2 Views70x$ 41.08x=$ - 0
971111Ribs Bilat. AP Chest70x$ 58.57x=$ - 0
1071120Sternum Min 2 Views35x$ 37.31x=$ - 0
1172040Spine Cervical AP/Lateral35x$ 44.55x=$ - 0
1272070Spine Thoracic AP/Lateral35x$ 36.93x=$ - 0
1372080Spine Thoarcoulumbar35x$ 38.81x=$ - 0
1472100Spine Lumbosacral AP/Lateral35x$ 44.55x=$ - 0
1572170Pelvis AP View35x$ 36.93x=$ - 0
1672200Sacroiliac Joint < 4 Views35x$ 38.81x=$ - 0
1772220Sacrum/Coccyx Min 2 Views35x$ 44.55x=$ - 0
1873000Clavicle Complete35x$ 31.28x=$ - 0
1973010Scapula Complete35x$ 26.65x=$ - 0
2073030Shoulder Comp. Min. 2 Views35x$ 38.96x=$ - 0
2173060Humerus Min. 2 Views35x$ 32.87x=$ - 0
2273070Elbow AP/Lateral Views35x$ 32.87x=$ - 0
2373090Forearm AP/Lateral Views35x$ 32.87x=$ - 0
2473100Wrist AP/Lateral Views35x$ 37.90x=$ - 0
2573120Hand 2 Views35x$ 35.19x=$ - 0
2673120Hand 2 Views35x$ 35.19x=$ - 0
2773140Finger/Fingers Min. 2 Views35x$ 43.45x=$ - 0
2873502Hip Min Unilateral 2 Views35x$ 53.82x=$ - 0
2973522Hips Bilateral 2 Views/each35x$ 60.82x=$ - 0
3073552Femur 2 Views35x$ 40.11x=$ - 0
3173560Knee AP/Lateral Views35x$ 38.28x=$ - 0
3273565Knees Bilateral 2 Views/each35x$ 45.23x=$ - 0
3373590Tibia/Fibula AP/Lateral35x$ 35.58x=$ - 0
3473600Ankle AP/Lateral Views35x$ 36.96x=$ - 0
3573620Foot AP/Lateral Views35x$ 31.72x=$ - 0
3673630Foot Complt. Min 3 Views35x$ 32.64x=$ - 0
3773650Calcaneus Min. 2 Views35x$ 33.55x=$ - 0
RADIOLOGYSample ProcedureEstimated # of Procedures for the Contract TermAverage Medicare Rate/ Proc.% of Medicare (same as page 2)Total
3873660Toe/Toes Min. 2 Views30x$ 32.64x=$ - 0
3974018Abdomen Single AP View60x$ 33.55x=$ - 0
40R0070Transportation Fee 1 Patient70x$ 277.60x=$ - 0
41R0075-UNTransportation Fee 2 Patients *35x$ 277.60x=$ - 0
42R0075-UPTransportation Fee 3 Patients *35x$ 277.60x=$ - 0
43R0075-UQTransportation Fee 4 Patients *35x$ 277.60x=$ - 0
44R0075-URTransportation Fee 5 Patients *50x$ 277.60x=$ - 0
45R0075-USTransportation Fee 6 or more Patients *25x$ 277.60x=$ - 0
46Q0092Set Up Fee per procedure70x$ 30.33x=$ - 0
TOTAL (#1 thru #46)=$ - 0
*Note: Rates are divided between patients and bill appropriat portion per patient.
RADIOLOGYOther ProceduresEstimated Numbers for the Contract TermRate per ItemTotal
47Employee Chest per procedure10x=$ - 0
48After Hours fee per trip200x=$ - 0
49STAT fee per patient, per visit200x=$ - 0
TOTAL (#47 thru #49)=$ - 0
Basis of AwardGRAND TOTAL
(All Line Items)$ - 0
*

California Department of Veterans Affairs Solicitation Number: 26CRY001

Page &P of &N

File details come from the government source that posted it. Updated .