At face value, your question seems to relate specifically to setting dollar amount charges for items and services. The best place to start is with the CMS definition of charges as the charges should be related to the cost of the item or service. The information is in the Provider Reimbursement Manual (one of the few paper manuals on the website) - part 2, section 2202.4. The individual hospital mark up will be unique to every hospital and it should reflect the hospital's CCR. Especially in this day of pricing transparency, a defensible pricing policy is important.
There are so many different methodologies that can be utilized for price setting. Drivers include costs, contracts, setting, technology, corporate strategy, etc. I am providing the link to the NAHRI Journal from January 2021. See page 21 for information on price transparency and rational pricing methodologies.
Comments
I am looking for a policy and procedure for setting charges for the CDM. Does any one have a policy shell that they are willing to share?
I would be interested in this as well.
At face value, your question seems to relate specifically to setting dollar amount charges for items and services. The best place to start is with the CMS definition of charges as the charges should be related to the cost of the item or service. The information is in the Provider Reimbursement Manual (one of the few paper manuals on the website) - part 2, section 2202.4. The individual hospital mark up will be unique to every hospital and it should reflect the hospital's CCR. Especially in this day of pricing transparency, a defensible pricing policy is important.
There are so many different methodologies that can be utilized for price setting. Drivers include costs, contracts, setting, technology, corporate strategy, etc. I am providing the link to the NAHRI Journal from January 2021. See page 21 for information on price transparency and rational pricing methodologies.