Chargemaster

Chargemaster is a comprehensive list of all the individual services and items billable to a hospital patient or a patient's health insurance provider. In the United States, the chargemaster, sometimes called a charge description master (CDM), is a universal feature of the health care payment system.

Overview

The chargemaster plays a crucial role in the revenue cycle process of a healthcare organization. It contains thousands of hospital services, procedures, and goods for which a patient or insurance company can be billed. Each item in the chargemaster has a unique identifier and a set price, which may vary widely from hospital to hospital.

Components

The chargemaster typically includes the following components:

• Item number: A unique identifier for each service or item.
• Item description: A brief description of the service or item.
• Charge: The price that the hospital asks for the service or item.
• Revenue code: A code that categorizes the service or item for accounting and reporting purposes.
• CPT/HCPCS code: A code that identifies the service or item according to the Current Procedural Terminology (CPT) or the Healthcare Common Procedure Coding System (HCPCS).

Criticism

The chargemaster has been criticized for its lack of transparency and for the high and seemingly arbitrary prices it contains. Critics argue that patients and their families are often unable to understand the chargemaster prices or to predict their healthcare costs. In response to these criticisms, some states have passed laws requiring hospitals to make their chargemasters public.

See also

• Health care in the United States
• Health insurance in the United States
• Medical billing