Common Chargemaster Questions
These common chargemaster questions cover topics such as chargemaster reviews, pricing methodology, sample audits, and ongoing maintenance services. With practical answers designed for smaller hospital teams.
Revenue Simplified works primarily with rural and community hospitals where chargemaster decisions can directly affect reimbursement, compliance, and revenue integrity. These answers cover many of the questions hospital leaders, business office teams, and revenue cycle staff ask when considering a chargemaster review or ongoing CDM maintenance.
What is a chargemaster review?
A chargemaster review is a detailed evaluation of your hospital’s Charge Description Master (CDM) to identify potential pricing, coding, and maintenance issues. We look for items such as charges below Medicare reimbursement, charges below established pricing benchmarks, outdated or deleted CPT/HCPCS codes, and other areas that may need attention.
Many chargemaster questions begin with understanding whether pricing, coding, or compliance issues are already present in the CDM.
What types of hospitals do you work with?
Revenue Simplified specializes in working with rural, community, and Critical Access Hospitals. Our services are designed for hospitals that may not have the time or dedicated resources to continuously review and maintain their chargemaster.
What information do you need to review our chargemaster?
Typically, we request an Excel export of your current chargemaster along with approximately 12 months of usage data. The files generally include the item number, description, department, revenue code, CPT/HCPCS code, current charge, and usage. If you’re unsure what reports to provide, we can help identify the information needed from your hospital system.
Do you offer a free sample review?
Yes. We offer a limited sample review of your chargemaster at no cost or obligation. The sample is designed to show your team actual examples of the pricing and coding issues our review may identify before you make a decision about moving forward.
What kinds of issues do you typically find?
Every hospital is different, but common findings include charges below Medicare reimbursement, charges below the hospital’s desired pricing benchmark, deleted or outdated CPT/HCPCS codes, replacement codes that may need to be updated, inconsistent pricing, and items with little or no recent usage.
Our goal is not simply to produce a large list of changes. We help identify and prioritize the items that deserve your attention.
Do you recommend that every identified charge be changed?
No. Our reports provide recommendations and supporting information so your hospital can make informed decisions. Your hospital maintains control over which changes are approved and implemented.
How do you determine recommended pricing?
Pricing recommendations can be based on current Medicare reimbursement and a benchmark selected with the hospital. Many rural and Critical Access Hospitals use a multiple of Medicare as one reference point when evaluating charges. We work with each hospital to determine an appropriate methodology rather than applying the same pricing strategy to every facility.
Do you only review pricing?
No. Pricing is an important part of the review, but chargemaster maintenance also involves coding. We review the CDM for issues such as deleted or outdated CPT/HCPCS codes, replacement codes, annual code changes, and other items that may require attention.
What happens after the initial chargemaster review?
We don’t believe a chargemaster should be reviewed once and then forgotten. Our ongoing maintenance services help hospitals keep their CDM current as Medicare reimbursement, CPT/HCPCS codes, and other requirements change. This includes annual updates as well as continued review throughout the engagement.
Can you help us implement approved changes?
Yes. Depending on your hospital’s needs and system access, we can assist with organizing approved changes and, when appropriate, help implement them. Our goal is to make the process manageable rather than simply delivering a report and leaving your staff to sort through it.
How much staff time does the review require?
We try to keep the burden on hospital staff to a minimum. Once we receive the necessary files, we perform the analysis and organize the findings for your team. Your staff can focus on reviewing recommendations and making decisions rather than manually analyzing thousands of chargemaster items.
How do we get started?
The easiest way to get started is with a free sample review. Send us your chargemaster and available usage information, and we’ll review a portion of the data to show you examples of what we find.
There is no cost or obligation for the sample review.
If you have additional chargemaster questions before sending files, we can review those with your team first.
How often should a chargemaster be reviewed?
We recommend a comprehensive chargemaster review every year. Annual maintenance keeps your chargemaster current with CMS updates, new and deleted CPT/HCPCS codes, pricing changes, and evolving compliance requirements. Regular reviews also help identify revenue opportunities, reduce billing errors, and ensure your organization is capturing appropriate reimbursement—because every dollar counts.
Still Have Questions?
Have questions about your hospital’s chargemaster? We’re happy to discuss your current CDM and show you what a review may uncover.
Experience You Can Reach
Revenue Simplified works directly with hospital leadership, business office teams, department managers, and IT staff. You work with the person reviewing your chargemaster. Questions are answered by someone familiar with your hospital’s files, decisions, and previous reviews.
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