Base Profile: https://www.hl7.org/fhir/chargeitem.html

Common use cases include:

Find Charges for a Patient
Find Charges from an Encounter
Add Charges to a Patient’s account

ModMed has several different flavors of ChargeItem depending on each practice’s unique configuration.

Practices which have EMA-only (no MMPM) will notice the following:
- Charges are only available once an encounter is finalized
- Charges cannot be created for these practices (since they do not have MMPM, you’re application should be sending charges to the practice’s PM system)
- There are no INBOUND charges for these practices
- All charges will reference an encounter in EMA as this is the only way to generate a ChargeItem.
Practices which use MMPM as their PM system will notice the following:
- INBOUND charges may be coming from other applications
- Not all Charges will be associated to an encounter

The following attributes are supported:

Field Name	Notes
id	The unique ID for a ChargeItem
financialTransaction*	Custom Extension designed to replicate HL7 DFT
financialTransactionId	ID of the transaction. This is not used for CREATE. One will be returned to you upon a CREATE.
transactionStatus	Charged\|
totalCost	The totalCost of a financialTransaction if it cannot or will not be computed by other inputs. valueMoney: currency USD
attendingProviderId	Attending Provider NPI or PMSID Goes here
referralProviderId	Referral Provider NPI or PMSID Goes here
locationId	Location NPI or PMSID Goes here
businessUnitId	Business Unit Id Goes here
transactionId	Transaction Id Goes here
sendingFacility	Global Code from MSH Header Goes here
receivingFacility	Firm Code from MSH Header Goes here
financialTransactionDetail*	Custom Extension designed to replicate FT1 segment of an HL7 DFT NOTE: You can add multiple financialTransactionDetail(s).
financialTransactionDetailId	ID of the transaction. This is not used for CREATE. One will be returned to you upon a CREATE. This will be used to support the READ in the future.
transactionType	CG - Charge is the only type supported at this time
performingProviderId	Performing Provider NPI or PMSID Goes here
code	CPT Code
unitCost	valueMoney
quantity	valueDecimal
description	valueString
postingDate	valueDateTime
transactionPeriod	valuePeriod
diagnosisDetail	Custom Extension designed to replicate the DG1 segment of an HL7 DFT NOTE: You can add multiple diagnosisDetail(s)
diagnosisDetailId	valueString ID of the diagnosis. This is not used for CREATE. One will be returned to you upon a CREATE. This will be used to support the READ in the future.
diagnosisDetailCode	valueCoding ICD-10 codes are supported at this time.
procedureDetail*	Custom Extension designed to replicate FT1 segment of an HL7 DFT NOTE: You can add multiple procedureDetail(s)
procedureDetailId	ID of the procedure. This is not used for CREATE. One will be returned to you upon a CREATE. This will be used to support the READ in the future.
procedureCode	valueCoding
anesthesiaCode	valueCoding
anesthesiaMinutes	valueString
anesthesiaProviderId	valueString Anesthesia Provider NPI Goes Here
procedureType	valueString
procedureCodeModifier	valueString Procedure Charge Code Modifier Goes here NOTE: You can add multiple procedureCodeModifier(s).
status	planned \| billable \| not-billable \| aborted \| billed \| entered-in-error \| unknown NOTE: Only ‘billable’ is supported at this time.
occurrenceDateTime	valueDateTime
subject	Patient Reference
context	Encounter ID (if known) NOTE: This is to be built out in the next release.
reason	valueCoding NOTE: Only ICD-10 codes are supported at this time.

The Following Operations are supported:

ChargeItem READ
ChargeItem SEARCH
ChargeItem CREATE

ChargeItem READ

HTTP Request	Method	Action
{base url}/{firm_url_prefix}/ema/fhir/v2/ChargeItem	GET	Get All ChargeItems for a Practice
{base url}/{firm_url_prefix}/ema/fhir/v2/ChargeItem/CHG\|{id}	GET	Get a specific ChargeItem
{base url}/{firm_url_prefix}/ema/fhir/v2/ChargeItem/INBOUND	GET	Get all Inbound Charges for a Practice
{base url}/{firm_url_prefix}/ema/fhir/v2/ChargeItem/INBOUND\|{id}	GET	Get a specific inbound Charge for a Practice

ChargeItem CREATE

If your application is planning on sending charges into MMPM, this will require some additional setup and configuration. It is recommended that you speak with whomever provided you access to the MMI Sandbox.

Practices which have EMA-only (no MMPM) will notice the following:
- Charges are only available once an encounter is finalized
- Charges cannot be created for these practices (since they do not have MMPM, you’re application should be sending charges to the practice’s PM system)
- There are no INBOUND charges for these practices
- All charges will reference an encounter in EMA as this is the only way to generate a ChargeItem.
Practices which use MMPM as their PM system will notice the following:
- INBOUND charges may be coming from other applications
- Not all Charges will be associated to an encounter

When generating charges for a customer, here are a few things you’ll want to consider. First, if you pass in a ‘unitCost’ value, it will override the ‘Fee Schedule’ that the customer has configured for the particular CPT code. So, if you want to do that (which may be the case in some scenarios), be sure to pass it in. It will take the Quantity and multiply it by that value. If you do not know or want to use the Fee Schedule already configured for that CPT code, do not pass in ‘unitCost’ - that way it will simply default to what the customer has configured.

The ‘transactionID’ is something you would pass in that may mean something to you or your customer. It will appear in the UI and they can search on it if you need to reference it for any reason.

Some customers have a setting which automatically creates bills from Charges assuming the information needed is there.

Customers that use this functionality have an ‘Inbound Charges’ queue in their ‘Financials’ experience:

If they are Auto-creating bills from charges, you may want to instruct your customers to check the New Bills tab if they are looking for something they are expecting to be here.