The file posted below titled “Standard Charges” reflects charges for items and services provided by CalvertHealth Medical Center. This file is commonly referred to as the hospital’s charge master dictionary, charge description master, or simply “charge master”. In Maryland, the Health Services Cost Review Commission (HSCRC), a state regulatory government agency, regulates the rate or standard gross charge for hospital services. The HSCRC sets hospital rates at least annually.
In accordance with the Centers for Medicare & Medicaid Services (CMS), CalvertHealth Medical Center, and all other Maryland hospitals, will post its charge master on a regular basis to coincide with the HSCRC hospital rate setting guidelines. The posted charge master reflects CalvertHealth Medical Center itemized charges only and does not include physician or other provider services, commonly referred to as professional fees, which are separate from the hospital bill. Please note the gross standard charges listed are the same for services rendered in a hospital inpatient, outpatient, or emergency department setting.
Additionally, this file is in accordance with the CMS Hospital Price Transparency requirements effective January 1, 2021. This file provides the community with a machine-readable digital file containing the gross standard charges and prompt-pay discount charges as regulated by the HSCRC. Per the Code of Maryland Regulations (10.37.10.26); a patient shall receive a 2-percent discount by paying upon discharge or a 1-percent discount by paying within 30 days of discharge. Furthermore, within the state of Maryland there are not payer-specific negotiated charges but rather commercial payers are entitled to the same prompt pay discount of 2% if payment is made at the earlier of the end of each regular billing period or upon discharge from the hospital and 1% discount if payment is within 30 days of the earlier of the end of each regular billing period or discharge. It should also be noted effective April 1, 2023, Medicare and Medicaid’s public payer differential or discount is 8.7% or 91.3% of all standard gross charges. Medicaid Managed Care Organizations (MCO’s) public-payer differential is 6.7% or 93.3% of all standard gross charges.
Although the state (HSCRC) sets hospital rates, hospital charges may fluctuate during the course of the year within the guidelines set forth by HSCRC. Charges on individual hospital bills may be different from the charges posted here because of changes during the course of the year. This is both allowable and normal as hospitals adjust charges frequently to comply with other HSCRC regulations.
The other file posted below titled “Shoppable Services” is also in accordance with the CMS Hospital Price Transparency requirements effective January 1, 2021 regarding the mandate of hospitals to post a consumer-friendly display of shoppable services. CMS defines a shoppable service as a service “that a health care consumer can schedule in advance.” In addition, CMS specified 70 hospital shoppable services should be made public by the hospital with a charge if performed by the hospital or noted if it is not performed by the hospital. These shoppable services are identified by a “*”.
The file defines each shoppable service by a service category of CalvertHealth Medical Center and prominently displays the estimated total charge and categorized by applicable charge buckets. Additionally, each shoppable service is identified by a common service billing code.
As stated for the machine-readable digital charge master file; the shoppable service file only reflects CalvertHealth Medical Center hospital charges and does not reflect physician or other provider services, commonly referred to as professional fees, which are separate from the hospital bill.
The HSCRC does not set an approved charge for any hospital episode or bundle of services. HSCRC sets annual hospital charges per unit, such as charge per patient day, charge per operating room minute, charge per imaging procedure or laboratory test, etc. Therefore, these figures are only estimates. The actual charge for your hospital shoppable service may be higher or lower based on factors specific to your case. The factors include but are not limited to your length of stay in the hospital, the complexity of your medical condition, and state of Maryland pricing regulations. If you have questions relating to your scheduled service, please contact the Patent Access Service Center at 410.414.APPT (2778) or toll-free at 1.855.414.APPT (2778). If you have already received services and have questions about your hospital bill, please contact our Patient Financial Services department at 410.535.8248.
Standard Charges
Shoppable Services
