I code ED for my facility and am looking for guidance on developing the chargemaster. What goes into calculating the charges? Do we use only the cost of supplies used or do we include nursing time and the cost of use of the facility? Should anything else included?
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Wiki Chargemaster
- Thread starter valcarr
- Start date
laqbrown
New
Chargemaster - ED
Did you happen to find an answer to your question? I am about to look at the chargemaster for a group of ED physicians that I started working for last month and I want to be sure that I'm giving them the appropriate feedback. Most supplies (i.e., surgical gloves, surgical trays, etc.) are not separately billable, correct? Thanks in advance for your help.
Did you happen to find an answer to your question? I am about to look at the chargemaster for a group of ED physicians that I started working for last month and I want to be sure that I'm giving them the appropriate feedback. Most supplies (i.e., surgical gloves, surgical trays, etc.) are not separately billable, correct? Thanks in advance for your help.
jimbo1231
Expert
Two Different Charge Masters
I think you are talking about different chargemasters. Laq, I think you are talking about an ED physician fee schedule. And you are right that supplies are not separately billible. There are different approaches to ED physician fee schedules. Many use RBRVS values with a conversion factor that is at some multiple of the CMS CF. Others will look at various payer payments, competitior info etc to come up with fees.
Val. Developing a hospital CDM is a very specialized field. But I believe many of the supplies etc are set at cost plus. The key to the ED facility CDM is that all billible services, procedures, infusions, injections, meds etc are in the CDM and priced out so they are billed when appropraitte. As to the Levels, the CMS fee schedule is sometimes used as a basis, with fees set at a percentage above Medicare reimbursement. But as I said hospital cdms are a specialized field and there should be someone at your facility that can help you.
jim
I think you are talking about different chargemasters. Laq, I think you are talking about an ED physician fee schedule. And you are right that supplies are not separately billible. There are different approaches to ED physician fee schedules. Many use RBRVS values with a conversion factor that is at some multiple of the CMS CF. Others will look at various payer payments, competitior info etc to come up with fees.
Val. Developing a hospital CDM is a very specialized field. But I believe many of the supplies etc are set at cost plus. The key to the ED facility CDM is that all billible services, procedures, infusions, injections, meds etc are in the CDM and priced out so they are billed when appropraitte. As to the Levels, the CMS fee schedule is sometimes used as a basis, with fees set at a percentage above Medicare reimbursement. But as I said hospital cdms are a specialized field and there should be someone at your facility that can help you.
jim
LTibbetts
Guest
I know that at our facility, we do not bill for any supplies that are under $ 10.00 (such as bandaid and stuff like that), so that is one of our factors in our facility fee charging. You also have to take into account the room charges, electricity, over head costs for the er dept, etc, and things like that. I hope that helps. I may have misunderstood your question and if so, my appologies