News: Largest hospitals’ workarounds for price transparency compliance
Some of the largest hospitals in the country have approached the price transparency rule by providing some pricing information online, but not providing the healthcare common procedure coding system (HCPCS) codes for the services, according to a review of 20 hospital websites by ADVI Analytics.
All 20 hospitals published some type of pricing information but not all seemed to “completely comply with the mandate” of showing information for 300 “shoppable” procedures. Analysts identified other common issues such as:
- not posting the information in a downloadable, useable format
- not providing the HCPCS codes
- “variability in hospitals’ terms for the pricing information”
The code 99203 (Level 3 Evaluation and Management code), a commonly billed Medicare service, was found to range in cost from $200 to $1,534. The radiology code 70450 (CT, head or brain, without contrast) ranged in cost from $90 to $2,033.
Writers of the analysis note that “while transparency in hospitals’ pricing may be beneficial to the average consumer and healthcare researchers, the implementation of this policy by hospitals has many hurdles to overcome before it can be useful.”
CMS will be auditing the compliance of the price transparency policy on a select sample of hospitals, and they are “cognizant of the complaints since its rollout at the beginning of January,” ADVI’s report states.
Editor’s note: The ADVI Analytics review can be found here. For more ACDIS coverage of the price transparency ruling, click here.