The Price File, also known as the Charge Description Master (CDM) consists of two master lists of charges related to all services including professional fees, supplies, devices, vaccines, radiopharmaceuticals, and room accommodation charge codes for inpatients and outpatients of O’Connor Hospital (OCH). There are currently two Price Files in use at OCH.
- The Hospital Billing (HB) Price File contains the facility related charges.
- The Professional Billing (PB) Price File contains the professional service-related charges.
Together, these two Price Files constitute the Charge Description Master (CDM) at O’Connor Hospital.
The Price File contains following elements:
- Procedure Master Number – A unique identifier within the system for each chargeable item.
- Procedure Record Name – A brief description of the service.
- CPT© (Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) code - This is a nationally recognized alphanumeric code utilized by the insurance industry and government payors to identify a particular service or item.
- Unit Charge – The gross dollar amount charged for each item to the account.
Variable prices may be present for services such as Reference Lab testing, implanted devices and items/services governed by other contracted rates. These prices may not be available for listing in the CDM since billed charges are based upon the charges as invoiced by the contractor to OCH at the time the service is provided.
Pharmaceutical prices listed are acquisition cost based. These costs may vary depending upon many factors such as date purchased and supplier. The patient may, therefore, see multiple prices for what appears to be the same medication. In practice, depending upon the dosage ordered by the provider, a patient may see multiple units of a single medication listed on a claim. The total of these units represents the total dosage provided to the patient. Due to these variances, we recommend that our patients contact the OCH Pharmacy department directly for the most accurate estimate based upon the providers medication orders.
Pricing in the OCH Price File is updated on July 1st of each year. Prices listed will correspond with prices as established by resolution of the Board of Supervisors of the County of Santa Clara for the current fiscal year. OCH reserves the right to modify these charges in accordance with organizational policies.
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CPT© codes, descriptions, and material only are copyright 2021 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT© . AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. CPT© is a trademark of the American Medical Association.
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