On August 2, 2018, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (CMS-1964-F) updating Medicare payment policies, specifically requiring hospitals “make available a list of their current standard charges via the Internet in a machine readable format and to update this information at least annually, or more often as appropriate.”
Peterson Health has analyzed current charges, based off CMS adjudicated claims through 06/30/2019. Standard charges will be updated yearly. Next update will be based off adjudicated claims through 06/30/2020.
DISCLAIMER AND EXPLANATION FOR STANDARD HOSPITAL CHARGES
This hospital determines its standard charges for patient services with the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for services provided at this hospital.
The chargemaster is similar in concept to the manufacturer’s suggested retail price (MSRP) on a vehicle. It is the starting price of each service performed and goods consumed associated with the individual patient’s treatment. The chargemaster rates are updated on a yearly basis to accurately reflect the hospital’s expenses to operate.
Standard charges shown in the attached file do not necessarily reflect what a patient may pay. Government insurance plans such as Medicare and Medicaid do not pay the chargemaster rates, but rather have their own set rates which hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with managed care payors and may or may not reflect the standard charges. Patients without commercial insurance or not covered by a government health care plan should contact the hospital prior to a procedure to discuss charges, alternative pricing, and payment terms.