Charge Description Master (CDM)

Flagler Hospital, Inc.

The Charge Description Master (CDM) for Flagler Hospital, Inc. is made available for your inspection based on the Centers for Medicare and Medicaid Fiscal Year 2019 Inpatient Prospective Payment System Final Rule, CMS-1694-F (which is part of FY 2019 IPPS/LTCH PPS). This document should not be used to accurately estimate or determine the final patient cost. It is provided for information only.

The charges contained in Flagler Hospital, Inc.’s CDM are the same for all patients, regardless of insurance company or coverage. However, the charges contained in the CDM may not reflect Flagler Hospital, Inc.’s actual reimbursement from all patients or insurance companies. Flagler Hospital, Inc.’s actual reimbursement is influenced by a variety of internal and external factors, including negotiated health plan rates, fixed government rates, individually negotiated package pricing, fixed fund distributions for indigent care populations, prompt payment discounts and the ability of unfunded patients ability to pay. Other factors affecting actual reimbursement could include whether a procedure was performed on an inpatient or outpatient basis, physician orders, comorbidities and complications, medical necessity and specialty services and procedures.

Charges referenced in this CDM were valid on Dec. 1st, 2018. These charges may have changed since this date due to new technology, added or eliminated services, goods and/or procedures, changes made by manufacturers or vendors, etc.

If you are comparing Flagler Hospital, Inc.’s CDM to the CDMs of other hospitals, it is important to note that descriptions and charges contained in the CDMs may vary from hospital to hospital in surrounding counties. Among the reasons for this variance, are that different hospitals may include different goods, supplies or procedures under a similarly named description.

Items or services that are special ordered by a physician are typically not included in room or procedure charges. Most treatments or services provided by ancillary department staff, such as respiratory therapy, laboratory, rehabilitation, pharmacy, etc., are separate distinct services that we are required to bill separately.

Flagler Hospital, Inc. does not employ the physicians that may provide service or care during hospitalizations. These include (but are not limited to) emergency room physicians, radiologists, pathologists, anesthesiologists, surgeons and psychiatrists. Charges for any physician services are not included in the CDM. Physicians that provide service during a hospital stay bill separately from the hospital for their services.

Instructions for Reviewing the Charge Description Master and the Diagnosis-Related Groups:

To view Flagler Hospital, Inc.’s CDM, simply scroll to the service line you are interested in seeing. Once selected, you will see the actual charge from the hospital CDM. Each line will include Flagler Hospital, Inc.’s charge code number, the clinical chargemaster description and our charge. The charge code number is Flagler Hospital, Inc.’s. internal identifier. Should you have any questions, please reference this number; it will help us quickly identify the charge referenced in your inquiry and allow for a prompt and accurate response.

In addition we have also provided a list of our average charges for each diagnosis-related group (DRG) established under section 1886(b)(4) of the Social Security Act. Simply go to the bottom of the CDM spreadsheet and click on the tab labeled “DRG AVG’S 2019”. Scroll to the DRG line item you are interested in reviewing.

Download the complete Charge Description Master and DRG Case Rate Averages (XML) - Link

Please contact us at 904-819-4539 for specific price estimates or for further assistance.