Dilated eye examination with an intraocular pressure measurement and a direct ophthalmoscopic examination, or a slit-lamp biomicroscopic examination, to identify eye disorders or early signs of glaucoma.

Act of increasing the fee for the purchased diagnostic service before billing.

1. Method of cost containment in which the government places a ceiling or cap on total public and private health care expenditures for a specific population within a specified time period. This type of cost containment applies to expenditures by insurers and individuals. 2. In the hospital setting, a limit of total budget as a cost containment method in which participating hospitals share one projected budget and give out each hospital facility’s funds from that budget. Also called total budget .

Reimbursement method in which a managed care plan provides and pays for all health care services for an enrolled population of patients including physicians and hospitals. The plan accepts all risk for that population, which means it needs to keep costs for health care below the amount of premiums collected. A portion of the global cap may be withheld to pay for specialist care referred by primary care physicians. Each year excess funds may be either paid out or carried forward against future global capitation payments to the primary care physicians. Also called full-risk capitation, full-risk contract , or fully capitated .

1. All-inclusive payment for hospital and physician services (e.g., a surgery case with all preoperative and postoperative medical care in one fee). 2. Combined technical (equipment) and professional (physician) charges or payment.

Specific period of time during which all medical services pertaining to a condition or diagnosis are considered included in the payment for the initial surgery or treatment and may not be billed separately. Complications related to the procedure are considered outside of the global period and not included in payment for the initial surgery or treatment. Medicare global surgical policy (GSP) is from 0 to 90 days postoperatively.

Reimbursement method in which both the hospital and physician fees are packaged into one price (global fee) for a specific medical procedure such as coronary artery bypass graft (CABG) surgery. In addition, the global fee often includes diagnostic procedures, postsurgical recovery, rehabilitation, and follow-up office visits within a certain time period. Also called package pricing and bundling .

Medical service that has both a professional and technical component such as in some radiological procedures. CPT modifier -26 indicates the professional component and modifier -TC indicates the technical component. When billing if no modifier is present, it is assumed the physician provided the global service. Also see professional component and technical component .