How New Healthcare Price Transparency Rules May Affect Your Otolaryngology Services at Hospitals

Standard Charges

There are certain standard charges that hospitals must make public under the new rule. A standard charge is the regular rate established by a hospital for an item or service provided to a specific group of paying patients. For purposes of complying with the Hospital Price Transparency final rule, this includes five types of standard charges:

1. The gross charge (the charge for an individual item or service reflected on a hospital’s chargemaster, without any discounts).
2. The discounted cash price (the charge that applies to an individual who pays cash, or a cash equivalent, for an item or service).
3. The payer-specific negotiated charge (the charge that a hospital has negotiated with a third-party payer for an item or service).
4. The de-identified minimum negotiated charge (the lowest charge that a hospital has negotiated with all third-party payers for an item or service).
5. The de-identified maximum negotiated charge (the highest charge that a hospital has negotiated with all third-party payers for an item or service).

Source: Centers for Medicare and Medicaid Services