Hospitals

Hospitals

Hospital Price Transparency

Empowering patients with the necessary information to make informed health care decisions.

Key Provisions

Key Provisions
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Most institutions in the United States that are licensed as hospitals or otherwise approved as meeting applicable licensing requirements must post their standard charges prominently on a publicly available website.

For additional details on the definition of hospital refer to 45 CFR §180.20 and on the federally owned or operated hospitals already deemed to be in compliance refer to 45 CFR §180.30.

Standard charges must be posted two ways:

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Machine Readable File

Single machine-readable digital file containing the following standard charges for all items and services provided by the hospital: gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges.

For additional details on this requirement refer to 45 CFR §180.50.

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Consumer-friendly Display of Shoppable Services

Display of at least 300 “shoppable services” (or as many as the hospital provides if less than 300) that a health care consumer can schedule in advance. Must contain plain language descriptions of the services and group them with ancillary services, and provide the discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges.

For additional details on this requirement, including the use of price estimator tools, refer to 45 CFR §180.60.

Beginning January 1, 2021, we'll monitor and enforce these price transparency requirements. For hospitals that do not comply, we may issue a warning notice, request a corrective action plan, and impose a civil monetary penalty and publicize the penalty on a CMS website.

For additional details on monitoring and enforcement refer to 45 CFR Subpart C and for information on appealing a civil monetary penalty refer to 45 CFR Subpart D.

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Page Last Modified:
09/30/2020 01:42 PM