Chargemaster/Charge description master (CDM) – The complete list of all charges for every service offered by the provider.
CMS (Centers for Medicare and Medicaid Services) – CMS is a federal agency in the U.S. Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children’s Health Insurance Program (CHIP), and health insurance portability standards.
CPT (Current Procedural Terminology) – Current Procedural Terminology (CPT) is a medical coding set used to identify/categorize medical, surgical and diagnostic procedures.
De-identified minimum and maximum negotiated charge – These charges are the lowest and highest charges a hospital has negotiated with all third-party payers for an item or service.
Discounted cash price – The discounted rate a hospital would charge individuals who pay cash, or the cash equivalent, for an individual item, service or service package.
Freestanding location – Locations not categorized as Hospital Based and will not include an additional facility based fee.
Gross charges or standard charges – The dollar amount set for services before any discounts (retail price).
Hospital-based location – Hospital-based care is care provided at a location that is clinically integrated with a hospital. Hospital-based locations include an additional facility based fee.
MS DRG (Medicare Severity Diagnosis Related Grouper) – A unit of case-mix classification adopted by the federal government and some other payers as a prospective payment mechanism for hospital inpatients, in which diseases are placed into groups because related diseases and treatments tend to consume similar amounts of healthcare resources and incur similar amounts of cost. There are more than 700 DRG classifications.
Negotiated charges/Negotiated payments/Allowed payments – The total agreed upon rate of payment for services from a payer, inclusive of patient portion.
Patient cost estimate – A good faith estimate of approximate costs associated with healthcare services. This is not legally binding and actual costs may be higher or lower depending on the actual care given.