Hospital price transparency
Consumer-friendly display requirements
The consumer-friendly published list is a distinct disclosure from the comprehensive machine-readable file. Under 45 CFR 180.60, the list needs a plain-language description for each selected shoppable service, applicable standard charges, the relevant hospital location and setting, and the primary billing code used by the hospital.
The applicable charge types are payer-specific negotiated charges, clearly tied to payer and plan; discounted cash prices; and de-identified minimum and maximum negotiated charges. If the hospital does not offer a discounted cash price for a listed service, it lists the undiscounted gross charge instead. Corresponding ancillary services are included as applicable.
The list must be prominently displayed, identify the associated hospital location, and be easy to access without charge, registration, an account or password, or submission of personal identifying information. It must be searchable by service description, billing code and payer. The hospital must update the information at least annually and clearly indicate its most recent update date.
CMS leaves the list's online format to the hospital. A downloadable document is not automatically wrong, but the format must still satisfy the searchability and access requirements. A recommended acceptance check is to try the public list as a new visitor and search a service by each required search key. A qualifying personalized price estimator is an alternative route with different criteria; its permitted information collection should not be confused with the list's no-PII requirement.