ATTACHMENT 8 PRICE COST SCHEDULE.docx

DOCX document 48 KB Posted

Attached to
Q522--MO POR Teleradiology 648 09/01/2026-08/31/2027
Solicitation number
36C26026Q0869
Issued by

About this file

This is a Price/Cost Schedule attachment for a teleradiology physician services contract with the Department of Veterans Affairs Portland Healthcare System (VAPORHCS). The contractor must furnish key personnel to provide tele-radiology services to eligible VA beneficiaries, with services performed from the contractor's facility but directed to VAPORHCS located at 3710 SW US Veterans Hospital Road, Portland, OR 97207. The contract performance period runs from August 1, 2026, through July 31, 2027, for the base year, with option years available. Services must meet or exceed American College of Radiology Guidelines Practice Parameters and Technical Standards.

Pricing shall be based on a firm fixed percentage of Medicare rates effective at the time services are provided, with the same rate methodology applied throughout the contract life and used for future pricing of additional codes and procedures. Offerors must complete the price schedule for 20 line items spanning diagnostic imaging services including plain films (2,900 estimated annual exams), CT exams (1,750 base quantity plus specialty variants totaling approximately 3,180 exams), ultrasound (70 exams), MRI (155 exams), nuclear medicine (25 exams), and PET/CT (15 exams). The total estimated annual cost across all line items and option years is $603,880.00. Offerors must base pricing on current CMS rates, identify their CMS rate source with internet links, specify facility or non-facility PE designation, and submit all pricing spreadsheets in unlocked Microsoft Excel format without protected portions. No line items or codes may be left blank; expired or unusable codes must be annotated as "N/A" with replacement codes provided.

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ATTACHMENT 6 ORGANIZATIONAL CONFLICT OF INTEREST STATEMENT 8.20.2026.docx DOCX document
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ATTACHMENT 8: PRICE/COST SCHEDULE

?.## SCHEDULE OF SERVICES

The Contractor shall furnish all key personnel to provide services necessary to perform Tele-Radiology Physician Services to eligible beneficiaries of the Department of Veterans Affairs, Department of Veterans Affairs (VA) and the VA Portland Healthcare System (VAPORHCS).

The VA Radiology Services follow the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Tele-radiology services shall provide services that meet or exceed the American College of Radiology Guidelines Practice Parameters and Technical Standards | American College of Radiology (acr.org).

Place of Performance: Services shall be provided to the VAPORHCS, 3710 SW US Veterans Hospital Road, Portland OR 97207 from contractor facility.

Pricing Instructions:

Offerors must fill out the cells in the following columns in the Price Schedule for each Line-Item Number (LIN). For pricing and evaluation purposes, the current CMS rates should be used in completing each LIN for the base year. The same rates must be entered for option years.

Throughout the life of the contract the VA will pay the awarded firm fixed percentage of the Medicare rate effective at the time the service is provided by the Contractor.

This basis of the contractor’s proposed firm fixed percentage of Medicare rate will be used by the Government for future pricing of additional codes/procedures and for reimbursement under the contract. The basis of estimate used for your fixed price, i.e. the way that your price is calculated, shall remain the same throughout the life of the contract and may be validated by post award audits.

The Offeror shall complete the attached price schedule for the performance location proposed. No LINS or codes should be left blank. If for some reason a code on the schedule has expired or is for any other reason unusable, offerors shall annotate the Price per Code block with “N/A” or otherwise notate the replacement code.

The Offeror shall base pricing on the application of Medicare reimbursement rules. All spreadsheets must be submitted in Microsoft Excel and without protected/locked portions or other methods which prevent or do not facilitate expeditious pricing validation. PDF files and similarly constructed files are not acceptable.

Indicate source for CMS rate proposed (Identify source and Internet link): ________________________ Indicate the offeror’s CMS practice expense (PE) designation for the rate proposed: (facility or non-facility):

Period of Performance: BASE: 08/01/2026 – 07/31/2027

LIN No.
CPT Code
Mod
Description-Summary
Description-Detail
Est.

Qty.

Unit
Proposed Unit Cost
Estimated Total

Annual Cost

DR
Plain Films
2900
EA
CT
CT Exams
1750
EA
CT
CT Low Dose Cancer Screening (71271) & CT Thorax
10
EA
CTA
CTA Exams
650
EA
CT
CT Abd & Pelvis exams
850
EA
CT
CT ABD & PELV 1/>REGNS
10
EA
CTA
CT ANGIO ABDOMINAL ARTERIES W/RUNOFF
50
EA
US
Ultrasound (US) Exams
50
EA
US
US Head & Neck (thyroid)
10
EA
US
US Arterial Duplex
10
EA
MRI
MR Exams
100
EA
MRI
MR Abdomen Exams
25
EA
NM
NM
25
EA
MRI
MR Prostate
15
EA
PET/CT
PET/CT
15
EA
N/A
2D Mammography Single Breast Exam
0
EA
N/A
3D Mammography single breast Exam
0
EA
MRI
MRI Cardiac-cpt code 75557, 7559, 75561
10
EA
CT
COMPUTER TOMOGRAPHY, HEART WITH 75572
10
EA
CT
COMPUTER TOMOGRAPHY HEART WITH 75573
10
EA

TOTAL

Total for base performance period and all option years: $603,880.00

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