Grouping charge items definition


Based on this discussion Pricing non medical services we agreed that the best way to price all healthcare services by using ChargeItemDefinition.

My question here, if i want to give specific provider/payer list of prices, or if i want to differentiate the price based on contract. Is it good practice here to create multiple lists/groups of ChargetItemDefinition ? if yes then how i can create groups ? or should i handle all such cases in applicability field ?


Typically you’d just have multiple ChargeItemDefinitions for the same billing code/device/medication/substance. Each would have different ‘applicability’ rules. Having ‘groupings’ wouldn’t really help. I’m personally a bit concerned that the ‘applicability’ modeling structure is going to make query difficult. Because it’s expression-based, I’m not going to easily be able to search for ChargeItemDefinitions that apply to a particular age, geographic location, insurance plan, etc. Perhaps the intention is to use useContext to help with that, but clearer guidelines would be helpful. Keep in mind that the resource is still draft, so feel free to submit change requests if you don’t feel it’s meeting your requirements.

1 Like