SEC. 126. PROFESSIONAL FEE OF PHYSICIANS AND DENTISTS.

   Any licensed physician or dentist who is a member of the medical or dental staff of any of the institutions maintained by the Department of Public Health, except an intern or resident, may charge and collect professional fees for direct medical or dental care furnished by him to any patient in an institution of the Department of Public Health, provided said patient is able to pay or carries sickness or accident insurance or medical expense indemnity insurance or is eligible for health care and related remedial or preventive service care under Public Law 89-97 of the United States (the 1965 Amendment to the Social Security Act) or Chapters 7 and 8 of Part 3 of Division 9 of the Welfare and Institutions Code, except as provided in Section 150 of the Charter.

(Added by Ord. 247-66, App. 9/19/66)

SEC. 127. DISPOSAL OF UNCLAIMED PERSONAL PROPERTY AT LAGUNA HONDA HOSPITAL.

   (a)   Definition Unclaimed Property. Personal property left at Laguna Honda Hospital for a period of more than 90 days after the patient has left the Hospital shall be considered unclaimed personal property.

   (b)   Disposition of Unclaimed Personal Property. Such unclaimed personal property shall be disposed of according to the following procedure:

      (1)   Notice shall be sent by certified mail to the former patient at his last known address advising that such unclaimed personal property must be claimed within 30 days.

      (2)   Such unclaimed personal property as remains after 30 days' notice to reclaim it shall be disposed of as follows:

         A.   Any sums of money which remain over and above Laguna Honda's charges shall be transmitted to the Controller of the City and County of San Francisco for deposit in the General Fund.

         B.   Other unclaimed personal property shall be delivered to the Purchaser of Supplies for disposition as provided for in Section 7.100 of the Charter of the City and County of San Francisco.

         C.   Proceeds derived from the sale of unclaimed property are to be deposited with the City Treasurer and used exclusively for such items that may be of general benefit for the patients of Laguna Honda Hospital and which are not provided for them by any other appropriation.

(Added by Ord. 277-73, App. 7/13/73)

SEC. 128. PATIENT RATES.

   The Board of Supervisors of the City and County of San Francisco does hereby determine and fix the proper reasonable amounts to be charged to persons for services furnished by the Department of Public Health as follows, which rates shall be effective for services delivered as of July 1, 2024, through June 30, 2026.

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
San Francisco Health Network
The San Francisco Health Network is the Department of Public Health’s system of care, which includes Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and the network of Community Primary Care Clinics. Patient Rates listed under this section, labeled “San Francisco Health Network,” apply to all providers that fall under the San Francisco Health Network.
Clinical Lab, Supplies & Drugs	Special Price Lists are located at 1001 Potrero Avenue, ZSFG, incorporated into this provision by reference as if specifically set forth herein. Such rates are subject to change by the Director of Health based on increases or decreases to procurement cost of the individual supplies and medications. These Special Price Lists are posted on the California Department of Health Care Access and Information website (https://hcai.ca.gov).
General Clinic
Initial Patient
Evaluation & Management (E/M) Expanded Exam	Visit	702	723
E/M Detailed Exam	Visit	801	825
E/M Comprehensive Exam	Visit	1,072	1,104
E/M Complex Exam	Visit	1,338	1,378
Established Patient
E/M Brief Exam	Visit	327	337
E/M Focused Exam	Visit	388	400
E/M Expanded Exam	Visit	511	526
E/M Detailed Exam	Visit	725	747
E/M Comprehensive Exam	Visit	1,130	1,164
Consultation
E/M Expanded Consult	Visit	680	700
E/M Detailed Consult	Visit	763	786
E/M Comprehensive Consult	Visit	1,008	1,038
E/M Complex Consult	Visit	1,194	1,230
E/M Add On
Prolong E/M Service	15 minutes	90	93
Complex E/M Service Add on	Visit	41	42
Home Patient Visits
Initial Patient
E/M Brief Exam	Visit	157	162
E/M Low Severity Exam	Visit	225	232
E/M Moderate Severity Exam	Visit	526	542
E/M High Severity Exam	Visit	640	659
Established Patient
E/M Brief Exam	Visit	157	162
E/M Low to Moderate Severity Exam	Visit	242	249
E/M Moderate to High Severity Exam	Visit	370	381
E/M High Severity Exam	Visit	516	532

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG)
Diagnostic Radiology Anatomic Pathology All Other Special Services	Special Price Lists are located at 1001 Potrero Avenue, ZSFG, incorporated into this provision by reference as if specifically set forth herein. Such rates are subject to change by the Director of Health. These Special Price Lists are posted on the California Department of Health Care Access and Information website (https://hcai.ca.gov).
In-Patient Care
Medical Surgical	Day	9,769	9,769
Intensive Care	Day	22,460	22,460
Intensive Care - Trauma	Day	22,460	22,460
Coronary Care	Day	22,460	22,460
Stepdown Units	Day	14,103	14,103
Pediatrics	Day	9,343	9,343
Obstetrics	Day	7,645	7,645
Nursery
New Born	Day	4,177	4,177
Semi-Intensive Care	Day	14,901	14,901
Intensive Care	Day	22,459	22,459
Labor/Delivery Hours of Stay	Hour	363	363
Psychiatric Inpatient	Day	7,645	7,645
Psychiatric Forensic Inpatient - 7L	Day	7,645	7,645
Security Unit - 7D	Day	7,645	7,645
Skilled Nursing Facility	Day	3,059	3,059
Mental Rehab Unit	Day	2,528	2,528
Adult Residential Facility	Day	510	510
Respiratory Therapy
O2 Therapy	per 24 hours	407	419
Surgical Services
Minor Surgery I (Come & Go)	1st Hour	7,510	7,736
Minor Surgery I (Come & Go)	Add’l ½ Hour or portion	3,755	3,868
Minor Surgery II	1st Hour	8,198	8,445
Minor Surgery II	Add’l ½ Hour or portion	4,099	4,222
Major Surgery I	1st Hour	12,347	12,719
Major Surgery I	Add’l ½ Hour or portion	4,935	5,084
Major Surgery II	1st Hour	13,902	14,320
Major Surgery II	Add’l ½ Hour or portion	5,567	5,735
Major Surgery III	1st Hour	15,472	15,938
Major Surgery III	Add’l ½ Hour or portion	6,190	6,376
Surgery (3 Teams)	1st Hour	25,509	26,277
Surgery (3 Teams)	Add’l ½ Hour or portion	10,205	10,512
Major Trauma I	1st Hour	14,543	14,981
Major Trauma I	Add’l ½ Hour or portion	5,820	5,995
Interventional Radiology	1st Hour	6,688	6,889
Interventional Radiology	Add’l ½ Hour or portion	3,344	3,445
Recovery Room	1st Hour	4,782	4,926
Recovery Room	Each Add’l Hour or portion	2,391	2,463
Anesthesia	1st Hour	10,743	11,066
Anesthesia	Add’l ½ Hour or portion	5,362	5,523
Trauma Care
Trauma Activation - 900	Visit	29,924	29,924
Trauma Activation - 911	Visit	17,602	17,602
Trauma Critical Care	1st 1-74 minutes	9,371	9,371
Trauma Critical Care	Each add’l 30 min. or portion	2,342	2,342
ED Level 5 Team Trauma	Visit	17,602	17,602
Emergency Clinic
Level I	Room	556	556
Level II	Room	1,665	1,665
Level III	Room	3,563	3,563
Level IV	Room	5,869	5,869
Level V	Room	11,846	11,846
Resuscitation		8,208	8,208
Psychiatric Emergency Services
Psych Crisis – Level 1 ER Room	Room	1,135	1,135
Psych Crisis – Level 2 ER Room	Room	2,637	2,637
Psych Crisis – Level 3 ER Room	Room	4,143	4,143
Psych Crisis – Level 4 ER Room	Room	5,648	5,648
Psych Crisis – Level 5 ER Room	Room	7,156	7,156
Psych Crisis – Level 6 ER Room	Room	8,662	8,662
Medication Svs/Min.	per minute	27	27

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Community Primary Care
Dental Services
Initial Complete Exam	Visit	209	215
Periodic Exam	Visit	209	215
Prophylaxis - Adult	Visit	289	298
Prophylaxis - Child	Visit	275	283
Extract Single Tooth	Visit	416	429
One Surface, Permanent Tooth	Visit	335	345
Home Health Services
Skilled Nursing	Visit	728	750
Home Health Aide Services	Visit	386	398
Medical Social Services	Visit	1,004	1,034
Physical Therapy	Visit	798	822
Occupational Therapy	Visit	798	822
Speech Therapy	Visit	798	822

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Laguna Honda Hospital and Rehabilitation Center
In-Patient Care
Regular Hospital Rates
Acute	Day	7,047	7,047
Rehabilitation	Day	7,047	7,047
Skilled Nursing Facility	Day	1,508	1,508
All-Inclusive Rates
Acute	Day	9,248	9,248
Rehabilitation	Day	8,057	8,057
Skilled Nursing Facility	Day	1,756	1,756

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Community Behavioral Health Services
Outpatient Mental Health and Drug Medi-Cal Organized Delivery System
Psychiatrist/Contracted Psychiatrist/Physician	Hour	2,065.48	2,129.10
Physician’s Assistant	Hour	926.36	954.89
Nurse Practitioner	Hour	1,027.11	1,058.75
Registered Nurse	Hour	838.97	864.81
Certified Nurse Specialist	Hour	1,027.11	1,058.75
Alcohol and Drug Counselor	Hour	445.88	459.61
Licensed Vocational Nurse	Hour	440.73	454.31
Pharmacist	Hour	988.69	1,019.15
Licensed Psychiatric Technician	Hour	377.83	389.47
Psychologist/Pre-licensed Psychologist	Hour	830.67	856.25
Licensed Practitioner of the Healing Arts (MFT, LCSW, LPCC)/Intern or Waivered Licensed Practitioner of the Healing Arts (MFT, LCSW, LPCC)	Hour	537.55	554.10
Occupational Therapist	Hour	715.56	737.60
Mental Health Rehabilitation Specialist	Hour	404.43	416.88
Peer Recovery Specialist	Hour	424.65	437.73
Peer Support Specialist	Hour	94.36	97.27
Medical Assistant	Hour	302.97	312.30
Other Qualified Providers	Hour	404.43	416.88
Interactive Complexity	Occurrence	18.32	18.88
Sign Language or Oral Interpretive Services	Per 15 minutes	30.92	31.88
Mobile Crisis
Mobile Crisis	Per encounter	3,049.58	3,143.51
Transportation, mileage	Per mile	0.67	0.69
Transportation, staff time
Psychiatrist/Contracted Psychiatrist/Physician	Per 15 minutes	516.37	532.27
Physician’s Assistant	Per 15 minutes	231.59	238.72
Nurse Practitioner	Per 15 minutes	256.78	264.69
Registered Nurse	Per 15 minutes	209.74	216.20
Certified Nurse Specialist	Per 15 minutes	256.78	264.69
Alcohol and Drug Counselor	Per 15 minutes	111.47	114.90
Licensed Vocational Nurse	Per 15 minutes	110.18	113.58
Pharmacist	Per 15 minutes	247.17	254.79
Licensed Psychiatric Technician	Per 15 minutes	94.46	97.37
Psychologist/Pre-licensed Psychologist	Per 15 minutes	207.67	214.06
Licensed Practitioner of the Healing Arts (MFT, LCSW, LPCC)/Intern or Waivered Licensed Practitioner of the Healing Arts (MFT, LCSW, LPCC)	Per 15 minutes	134.39	138.53
Occupational Therapist	Per 15 minutes	178.89	184.40
Mental Health Rehabilitation Specialist	Per 15 minutes	101.11	104.22
Peer Recovery Specialist	Per 15 minutes	106.16	109.43
Peer Support Specialist	Per 15 minutes	23.59	24.32
Medical Assistant	Per 15 minutes	75.74	78.08
Other Qualified Providers	Per 15 minutes	101.11	104.22
Mental Health
24-Hour Service
Hospital Inpatient	Day	7,645	7,645
Skilled Nursing	Day	293.91	302.96
Adult Crisis Residential	Day	722.32	744.57
Adult Residential	Day	551.29	568.27
Therapeutic Foster Care (TFC) Service Model	Day	615.23	634.18
Day Services
Day Rehabilitation	Day	364.73	375.96
Day Rehabilitation	Half Day	243.16	250.64
Day Treatment Intensive	Day	781.80	805.88
Day Treatment Intensive	Half Day	521.20	537.26
Crisis Stabilization	Hour	352.16	363.01
Socialization	Hour	147.61	152.16
Substance Use Disorder (SUD)
Opioid Replacement Therapy (OTP)/Narcotic Treatment Program (NTP)
Methadone	Daily	37.46	38.61
Buprenorphine–Naloxone Combo	Daily	50.67	52.23
Buprenorphine Mono	Daily	50.12	51.66
Disulfiram –Perinatal	Daily	13.57	13.98
Buprenorphine Injectable (Sublocade)	Monthly	8,729.38	8,998.24
Naltrexone Injectable (Vivitrol)	Monthly	6,954.90	7,169.11
Naloxone HCL –2 pack (Generic)	Per pack of 2	109.34	112.70
Naloxone HCL –2 pack (Narcan)	Per pack of 2	149.22	153.81
SUD Residential Treatment
Level 3.2 Residential Withdrawal Management	Day	207.45	213.84
Level 3.1 Residential	Day	321.27	331.16
Level 3.3 Residential	Day	191.41	197.30
Level 3.5 Residential	Day	207.99	214.40

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Population Health & Prevention
Vital Records
Birth Certificate	Per Certificate	Rates Per California Health and Safety Code Section 103650
Death Certificate	Per Certificate	Rates Per California Health and Safety Code Section 103650
Permit-Disposition of Human Remains	Per Permit	Rates Per California Health and Safety Code Section 103650
Out-of-County Cross File Fee	Per Certificate	Rates Per California Health and Safety Code Section 103650
Letter of Non-Contagious Disease	Per Letter	15	15
Expedited Registration of Vital Event	Per Event	Rates Per California Health and Safety Code Section 103650
Expedited Documents	Per Delivery	30	30
After Hours Registration of Vital Event	Per Event	42	42
Reproduction of Documents	Per Page	2	2
Medical Marijuana ID Card
Medical Marijuana ID	Card	100	100

 

TYPE OF SERVICE	UNIT	AMOUNT
		2024-25	2025-26
Adult Immunization Clinic
Vaccines
Clinic Visits
Travel Health Visit (THV1)	Per Visit	70	70
Travel Health Visit (THV2) – Under Age 18 with Parent THV1	Per Visit	70	70
Registered Nurse Visit – Off-Site Location	Per Visit	200	200
Other Vaccines	Per Injection	Special Price List is located at 101 Grove Street, Adult Immunization and Travel Clinic, incorporated into this provision by reference as if specifically set forth herein, and not subject to change except by amendment to this provision. This Special Price List is posted on the San Francisco Department of Public Health Communicable Disease and Control Prevention website (https://www.sfcdcp.org/aitc/aitc-regular-prices-low-cost-or-free-vaccines/).

 

(Added by Ord. 313-96, App. 8/8/96; amended by Ord. 332-97, App. 8/19/97; Ord. 278-98, App. 8/28/98; Ord. 236-99, File No. 991389, App. 8/27/99; Ord. 20-00, File No. 000043, App. 2/11/2000; Ord. 218-00, File No. 001337, App. 9/8/2000; Ord. 13-01, File No. 002148, App. 1/26/2001; Ord. 173-01, File No. 011220, App. 8/10/2001; Ord. 151-02, File No. 021073, App. 7/12/2002; Ord. 34-03, File No. 030167, App. 3/13/2003; Ord. 189-03, File No. 030986, App. 7/25/2003; Ord. 185-04, File No. 040748, App. 7/22/2004; Ord. 178-05, File No. 050985, App. 7/29/2005; Ord. 197-06, File No. 060782, App. 7/21/2006; Ord. 195-07, File No. 070810, App. 8/3/2007; Ord. 164-08, File No. 080761, App. 7/30/2008; Ord. 153-09, File No. 090701, App. 7/15/2009; Ord. 177-10, File No. 100719, App. 7/23/2010; Ord. 157-11 , File No. 110708, App. 8/1/2011, Eff. 8/31/11; Ord. 167-12 , File No. 120604, App. 7/27/2012, Eff. 8/26/2012; Ord. 93-13 , File No. 130261, App. 5/31/13, Eff. 6/30/13 [retroactive]; Ord. 172-13 , File No. 130547, App. 8/2/2013, Eff. 9/1/2013; Ord. 170-14 , File No. 140628, App. 7/31/2014, Eff. 8/30/2014; Ord. 86-15 , File No. 150184, App. 6/18/2015, Eff. 7/18/2015 [retroactive]; Ord. 145-15 , File No. 150570, App. 8/6/2015, Eff. 9/5/2015; Ord. 152-16 , File No. 160635, App. 8/1/2016, Eff. 8/31/2016; Ord. 173-17, File No. 170681, App. 7/27/2017, Eff. 8/26/2017, Retro. 7/1/2017; Ord. 186-18, File No. 180586, App. 8/1/2018, Eff. 9/1/2018, Retro. 7/1/2017 and 7/1/2018*; Ord. 180-20, File No. 200844, App. 10/1/2020, Eff. 11/1/2020; Ord. 124-21, File No. 210646, App. 8/4/2021, Eff. 9/4/2021; Ord. 185-22, File No. 220686, App. 8/4/2022, Eff. 9/4/2022; Ord. 177-23, File No. 230662, App. 7/28/2023, Eff. 8/28/2023; Ord. 195-24, File No. 240600, App. 7/31/2024, Eff. 8/31/2024)

*Editor’s note:

   Section 3(b) of Ord. 186-18 states: “new rates established in this ordinance for Fiscal Year 2017-2018 shall be retroactive to July 1, 2017, and new rates established in this ordinance for Fiscal Year 2018-2019 shall be retroactive to July 1, 2018.”

SEC. 128.1. PATIENT RATES/FIRE DEPARTMENT EMS SERVICES.

   (a)   The Board of Supervisors approves the following fee schedule for Fire Department emergency medical services:

      (1)   Treatment without Transportation, a base rate fee of $365.00 per call.

      (2)   Basic Life Service, including transportation, a base rate fee of $1,642 per call.

      (3)   Advanced Life Service, including transportation, a base rate fee of $1,642 per call.

      (4)   Mileage if transported, an additional fee above the base rate of $31.00 per mile.

   (b)   Beginning with Fiscal Year 2011-2012, the fees set in this section may be amended without further action by the Board of Supervisors, to reflect changes in the Medical Consumer Price Index as determined by the Controller. No later than April 15th of each year, the Fire Department shall submit its current fee schedule to the Controller, who shall apply the price index adjustment to produce a new fee schedule for the following year.

   (c)   No later than May 15th of each year, the Controller shall file a report with the Board of Supervisors reporting the new fee schedule and certifying that: (a) the fees produce sufficient revenue to support the costs of providing the services for which each fee is assessed, and (b) the fees do not produce revenue which is significantly more than the costs of providing the services for which each fee is assessed.

(Added by Ord. 106-03, File No. 030624, App. 5/23/2003; amended by Ord. 185-05, File No. 050993, App. 7/29/2005; Ord. 165-08, File No. 080759, 7/30/2008; Ord. 170-09, File No. 090706, 7/21/2009; Ord. 174-10, File No. 100714, App. 7/23/2010)

SEC. 129. CHARITY CARE POLICY REPORTING AND NOTICE REQUIREMENT.

   Declaration of policy. It is the policy of the City and County of San Francisco that charity care-medical care provided to those who cannot afford to pay and without expectation of reimbursement-is a vital portion of community health care services. While San Francisco General Hospital is the primary provider of charity care services in San Francisco, private hospitals also have a responsibility to serve uninsured and poor patients. Nonprofit hospitals in particular have an obligation to provide community benefits in the public interest in exchange for favorable tax treatment by the government. It is essential that, on an ongoing basis, the City and County of San Francisco evaluate the need for charity care in the community given the City's responsibility to provide care to indigents. To plan for the continuing fulfillment of this responsibility, the City needs information from the hospitals in San Francisco on each hospital's policies on the availability of and criteria for charity care. For planning purposes, the City also needs information on the amount of charity care provided by each hospital. Upon receipt of such information, the City can better fulfill its mandate to provide care to indigents and fashion an appropriate response to unmet needs for charity care including the recommendation of budgetary, regulatory or other action at the State and Federal levels.

   To maximize the access to charity care within the community and to enhance the health of the public by informing individuals of the availability of charity care, it is further the policy of the City and County of San Francisco that each hospital notify patients of that hospital's policies on charity care. Such notice shall include visually prominent multilingual postings explaining the hospital's policy on charity care. It shall also be the policy of the City and County of San Francisco to require hospitals, when practicable, to verbally notify patients at the time of admission as to the availability of charity care and the process for applying or qualifying for such care.

(Added by Ord. 163-01, File No. 010142, App. 7/20/2001)

SEC. 130. DEFINITIONS.

   For purposes of Sections 129-137 of Article 3, certain words and phrases shall be construed as hereafter defined. Words in the singular include the plural, and words in the plural shall include the singular. Words in the present tense shall include the future. Masculine pronouns include feminine meaning and are not gender-specific.

   (a)   Bad Debt. The term "Bad Debt" means the unpaid accounts of any person who has received medical care or is financially responsible for the cost of care provided to another, where such person has the ability to pay but is unwilling to pay.

   (b)   Charity Care. The term "Charity Care" means emergency, inpatient or outpatient medical care, including ancillary services, provided to those who cannot afford to pay and without expectation of reimbursement and that qualifies for inclusion in the line item "Charity-Other" in the reports referred to in Section 128740(a) of the California Health and Safety Code, after reduction by the Ratio of Costs-to-Charges.

   (c)   Cost. The term "Cost" means the actual amount of money a hospital spends to provide each service, but not the full list price charged by the hospital for that service.

   (d)   Department. The term "Department" means the Department of Public Health of the City and County of San Francisco.

   (e)   Director of Health. The term "Director of Health" includes the Director of Health or a designee.

   (f)   Hospital. The term "Hospital" includes every entity in San Francisco licensed as a general acute care hospital, as defined by Section 1250(a) of the California Health and Safety Code, other than hospitals exempt from taxation under Section 6.8-1 of the San Francisco Business and Tax Regulations Code. For purposes of Section 131, the term "Hospital" shall also not include hospitals owned and operated by a nonprofit system that does not provide a significant level of service on a fee-for-service basis and whose annual financial statement is consolidated with a nonprofit health maintenance organization, filed with the California Department of Managed Health Care.

   (g)   Policies. The term "policies" means the hospital's criteria and procedures on the provision of charity care including any criteria and procedures for patient and community notification of charity care availability, the application or eligibility process, the criteria for determinations on eligibility for charity care and the appeal process on such determinations, and the hospital's internal accounting procedures for charity care.

   (h)   Ratio of Cost-to-Charge. The term "Cost-to-Charge" shall have the same meaning as that given by the Office of Statewide Health Planning and Development in the reports referred to in Section 128740(a) of the California Health and Safety Code and describes the relationship between the hospital's cost of providing services and the charge assessed by the hospital for the service.

(Added by Ord. 163-01, File No. 010142, App. 7/20/2001)