Q&A: Charging guidelines for drugs

Q: Is it recommended to charge for a drug when it's dispensed or upon actual administration of the drug?

A: Hospitals typically choose whether to charge drugs when they are dispensed for a patient or when they are actually administered to the patient. Prior to EMRs, the two most typical methods of charging drugs were from dispensing cabinets or via pharmacy dispensing the drug after filling the order. Dispensing cabinets can be set up in different locations to charge upon dispense. Typically, cabinets are in nursing units and surgery. There may also be a specialty-specific cabinet for anesthesia.

With the advent of EMRs and electronic medication administration records (MAR), many hospitals have progressed to charging drugs on actual administration. This is the most accurate means to charge for drugs. Typically, the ability to charge on administration is an
EMR setting applicable to the entire facility, so if every department is not set up on the same MAR, this option may not be possible.

For more information, see The Chargemaster Essentials Toolkit, Second Edition.