Attachment D2 - Price Work Sheet.pdf
PDF 144 KB Posted
- Attached to
- Q201--Escondido CBOC RFP
- Solicitation number
- 36C26220R0128
View the file
Other files
Show all 41
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
PRICE SCHEDULE
This is an indefinite delivery, indefinite quantity, (IDIQ) fixed-price contract. Prices in this schedule represent an all-inclusive rate including labor, facility, incidental costs, and overhead. Costs not incorporated into the contractor’s price will not be reimbursed by the Government.
The guaranteed minimum amount for this contract is $2,000.00. The maximum aggregate value of the orders that can be placed under this contract is $40,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.
The previous option year pricing will apply to any extension pursuant to FAR 52.217-8
BASE YEAR: October 15, 2020 – October 14, 2021
CLIN
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
0001 Primary Care Services at capitation rates per member per month
(PMPM)
PMPM 4,447
OPTION YEAR ONE: October 152021 – October 14, 2022
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
1001 Primary Care Services at capitation rates per member per month
PMPM 4,491
OPTION YEAR TWO: October 15, 2022 – October 14, 2023
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
2001 Primary Care Services at capitation rates per member per month
PMPM 4535
OPTION YEAR THREE: October 15, 2023 – October 14, 2024
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
3001 Primary Care Services at capitation rates per member per month
PMPM 4,580
OPTION YEAR FOUR: October 15, 2024 – October 14, 2025
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
4001 Primary Care Services at capitation rates per member per month
PMPM 4,625
OPTION YEAR FIVE: October 15, 2025 – October 14, 2026
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
5001 Primary Care Services at capitation rates per member per month
PMPM 4,671
OPTION YEAR SIX: October 15, 2026 – October 14, 2027
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
6001 Primary Care Services at capitation rates per member per month
PMPM 4,717
OPTION YEAR SEVEN: October 15, 2027 – October 14, 2028
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
7001 Primary Care Services at capitation rates per member per month
PMPM 4,764
OPTION YEAR EIGHT: October 15, 2028 – October 14, 2029
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
8001 Primary Care Services at capitation rates per member per month
PMPM 4,811
OPTION YEAR NINE: October 15, 2029 – October 14, 2030
NUMBER
DESCRIPTION OF
SERVICES UNIT
ESTIMATED
QUANTITY UNIT PRICE AMOUNT
9001 Primary Care Services at capitation rates per member per month
PMPM 4,859
All patients assigned to the contracted clinic shall have a minimum of a Level 3 Evaluation and
Management (E&M) exam performed and documented within the last 12 months by an authorized provider.
BASE PERIOD ESTIMATED TOTAL $_______________________
OPTION YEAR 1 ESTIMATED TOTAL $_______________________
OPTION YEAR 2 ESTIMATED TOTAL $_______________________
OPTION YEAR 3 ESTIMATED TOTAL $_______________________
OPTION YEAR 4 ESTIMATED TOTAL $_______________________
OPTION YEAR 5 ESTIMATED TOTAL $_______________________
OPTION YEAR 6 ESTIMATED TOTAL $_______________________
OPTION YEAR 7 ESTIMATED TOTAL $_______________________
OPTION YEAR 8 ESTIMATED TOTAL $_______________________
OPTION YEAR 9 ESTIMATED TOTAL $_______________________
AGGREGATED COST FOR BASE + ALL OPTION YEARS $_______________________
*CBOC ORDERING PROCEDURES: VA has the sole authority to assign Veterans treated by the
Contractor into the Primary Care Management Module (PCMM) software program used to track primary care clinic Veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining Veteran eligibility, enrollment eligibility, and patient vesting. Details can be found in section 6.2.1 of the Performance Work Statement.
File details come from the government source that posted it. Updated .