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Chargemaster

A hospital chargemaster is a comprehensive list of all the billable services and items provided by a hospital. The chargemaster captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges. Because hospitals operate 24 hours a day, seven days a week, a chargemaster can contain thousands of services and related charges.

Chargemaster amounts are almost never billed to a patient or received as payment by a hospital. The chargemaster amounts are billed to an insurance company, Medicare, or MassHealth. These payers then apply their reimbursement terms or contracted rates to the services that are billed. If a patient co-payment, coinsurance, or deductible is owed, these too are most often not based on chargemaster amounts but rather the payment terms determined by the insurer or government program.

In situations where a patient does not have insurance, patients may be eligible for free or reduced cost of health care services through various state public assistance programs as well as the hospital financial assistance programs (including but not limited to MassHealth, the premium assistance payment program operated by the Health Connector, the Children’s Medical Security Program, the Health Safety Net, and Medical Hardship). Such programs are intended to assist low-income patients taking into account each individual’s ability to contribute to the cost of his or her care.

For those individuals that are uninsured or underinsured, the hospital will, when requested, help them with applying for either coverage through public assistance programs or hospital financial assistance programs that may cover all or some of their unpaid hospital bills. You can find more information on our financial assistance policies or speak to a financial counselor at 508-473-1190 #8.

What is Not Included in the Chargemaster List?

The hospital’s chargemaster may not include charges for services provided by the doctors who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care.

The following provides a list of providers who may send a separate bill for any services provided in the hospital:

  • Your personal doctor, if he/she sees you in the hospital;
  • The surgeon who performs your procedure;
  • The anesthesiologist who works with the surgeon;
  • The emergency room physician who cared for you;
  • The radiologist who reads your x-rays or other imaging; and/or
  • Other doctors who may be consulted by your doctor during your time in the hospital.

Are Charges the Same for Every Patient?

The list of charges is the same for all patients. However, the total charges for an individual patient often vary from one patient to another for a number of reasons, including but not limited to:

  • How long it takes to perform the service or how long it takes you to recover in the hospital
  • Whether the service or procedure you receive is more or less difficult than expected
  • What kinds of medication you require
  • Whether you experience complications and need additional treatment and/or
  • Other health conditions you may have that may affect your care.

As mentioned above, chargemaster amounts are almost never billed to a patient or received as payment by a hospital.

Where Can I Find More Information About Hospital Costs?

If you would like more information about what your care might cost you or the hospitals’ financial assistance policy, please contact our patient financial services staff at 508-473-1190 #8.

Your health plan can also help you to understand your insurance coverage, which services will be covered, how much you will be billed, information on deductibles and your expected out-of-pocket responsibility.

Massachusetts Transparency Website

Through the Center for Health Information Analysis (CHIA), the state has created a website, CompareCare (https://www.masscomparecare.gov/about), for consumers to compare costs of medical procedures across the Commonwealth. CompareCare also includes quality metrics where available. Regarding the cost quotes, the CHIA website provides an estimate based on amounts paid to health care providers in previous years. To find out what your specific out of pocket costs will be, contact your health plan.

Chargemaster List

The information provided in this Chargemaster List is a comprehensive list of standard charges for each inpatient and outpatient service or item provided by a hospital, also known as a chargemaster. This list of services/items and the corresponding amounts are subject to change throughout the year. Therefore, the chargemaster should not be used by patients to estimate what their healthcare services are going to cost them out of their own pocket. For information about the cost of your care or financial assistance, please contact our patient financial services staff at 508-473-1190 #8.

Here is the list of average charges by Diagnosis Related Group (DRG).

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