Charge Master and the $0.00 claim guard
The Charge Master is where you set the price for every procedure your facility bills. Medipyxis will not let a claim leave the system for $0.00 — not one line at $0, not a claim total at $0, no escape hatch. This page shows how to set prices, how the pre-flight guard reads them, and what the biller sees when a price is missing.
Before you start
- You have the
billeroradminrole. - Your facility is active and you know which CPT/HCPCS codes you bill.
- If you use different rates for insurance vs. self-pay, you have both lists ready.
Open the Charge Master
Navigate to /facility/{facility_uuid}/billing/charge-master. The page opens with three tabs:
| Tab | What it holds |
|---|---|
| Insurance Charges | The per-unit price used when a claim is priced against an insurance payer. |
| Self-Pay Charges | The per-unit price used when the patient is self-pay. |
| Templates | Superbill templates (fixed CPT/HCPCS/ICD-10 code lists) you attach to visit types. |
Each rate is per-unit, per-code, per-facility. Add a code, set the amount, save.
How pricing flows into a claim
When a claim is drafted from a visit, priceClaimLine reads facility_charge_master for each procedure line:
- It matches the row by facility + CPT/HCPCS + insurance vs. self-pay context.
- It multiplies the per-unit rate by the units on the line.
- It writes the resulting charge onto the 837P service line before submission.
If a line has no row in the Charge Master, the price is $0.00 — and the pre-flight guard rejects the whole claim.
The $0.00 guard
Two rules stop a $0.00 claim from ever reaching a payer, and both are named requirements from April Alfaro (2026-08-27):
1. No line may have a $0.00 charge. Every service line on the 837P must carry a positive dollar amount. If any line is $0.00, submission is refused with a message that names the code:
Claim cannot be submitted — No price on file for CPT 97597 at At Home Wound Care, PLLC — add it in Charge Master.
2. The claim total must exceed $0.00. Even if every line individually passes some future relaxation of rule 1, the aggregate total is asserted separately:
Claim total is $0.00 — nothing is being billed. Add charges in Charge Master.
Both rules run before the claim reaches Stedi. Nothing at Stedi ever sees a $0 line. There is no "legitimate $0 line" escape hatch — a claim asking a payer for $0 is always a defect, and it is one this system exists to catch.
charge_amount, the reader looked for lineItemChargeAmount, and every claim went through with $0 lines. The whole prod set — 1,134 claims — priced at $0. The guard is now permanent, on both the electronic path AND the manual paths (Mark as Submitted, Fix & Resubmit, Send Fax).
The rejection message, made readable
Until 2026-08-27, the biller-facing rejection was mangled by the submit UI — the same message was printed twice, wrapped in JSON brackets, and titled "Stedi Submission Failed" even though the rejection was pre-flight (Stedi never saw it). It read:
Stedi Submission Failed — Claim is missing required field(s): No price on file for CPT 97597 at At Home Wound Care, PLLC — add it in Charge Master.: ["No price on file for CPT 97597 at At Home Wound Care, PLLC — add it in Charge Master."]
That was wrong three ways: duplicated message body, wrong prefix ("missing required field(s)" sent billers hunting for a blank box instead of Charge Master), and wrong blame (a pre-flight rejection never reached Stedi). It now reads:
Claim Not Submitted — Claim cannot be submitted — No price on file for CPT 97597 at At Home Wound Care, PLLC — add it in Charge Master.
Multiple missing codes are listed one per line, and the toast stays visible for 12 seconds because a multi-line list takes longer to read.
Steps — add a missing price
- From the rejection toast, note the CPT/HCPCS code.
- Open Charge Master for the facility → Insurance Charges (or Self-Pay Charges if the patient is self-pay).
- Click Add code → enter the CPT/HCPCS → enter the per-unit dollar amount → Save.
- Return to the claim in New Claim or the Coding Review drawer.
- Refresh the claim (or click Save & Next and come back). The price now hydrates onto the line, and the Expected Total is a real number.
- Submit.
Templates
The Templates tab is not a pricing surface — it holds superbill templates: fixed lists of CPT/HCPCS/ICD-10 codes you attach to visit types so a clinician sees the right code menu on the wizard. Templates carry no dollar amounts; those still come from Insurance Charges and Self-Pay Charges.
Result
Every claim leaving the facility has a positive charge on every line and a positive total. Any missing price surfaces immediately, in the biller's words, on the exact line that lacks a rate. When a biller adds the price, the same claim goes through on the next attempt with no code changes needed.
Troubleshooting
| Symptom | Likely cause | What to do |
|---|---|---|
| "No price on file for CPT XXXXX" on every claim for a new facility | The facility was set up without a Charge Master. | Add rates in Insurance Charges and Self-Pay Charges. |
| Rate is set but the claim still rejects with $0.00 | The rate exists in the wrong tab (self-pay vs. insurance) for this patient. | Confirm the patient's payment method on the claim; add the rate in the matching tab. |
| Rate is set correctly but the line still shows $0.00 in the drawer | The claim was drafted before you added the rate. | Re-open the claim; the Expected Total re-hydrates from Charge Master on load. Or open Edit in Full Form and save once. |
| Toast title says "Stedi Submission Failed" | You are on an older client build. | Refresh the page to pick up the corrected title ("Claim Not Submitted"). |
| A biller wants to submit a legitimately $0 line (e.g. no-charge follow-up) | There is no escape hatch — by design. | Do not attempt to bypass the guard. Book the encounter as non-billable in the Work Queue instead, or contact the payer directly. |