PRICE TRANSPARENCY: CONSUMER ESTIMATION TOOL AND MACHINE-READABLE FILE
In compliance with the Centers for Medicare and Medicaid Services (CMS) Final 2020 Price Transparency Rules, effective January 1, 2021, all hospitals in the United States annually must provide a machine-readable file containing negotiated charges (rates) for ALL items and services. Additionally, the rule requires that for 300 shoppable items and services only, hospitals must provide a consumer-friendly display of gross charge and negotiated charges (rates) or estimation tool. Accordingly, below you will find links to the consumer estimation tool and the machine-readable file.
The fees and/or costs provided via this tool are only estimates, and your final bill may be higher or lower than the estimate for various reasons including but not limited to differences in the number of conditions among patients having the same or similar primary procedures, differences in physician ordering practices, unforeseen complications, etc. Moreover, this is not a guarantee of your benefit plan coverage or payment, and the actual payer and patient portion reflected in your final bill may also be higher or lower.
In some instances, where no recent historical claims and/or payment information is available for the payer plan and the item or service you have selected, the estimate may be for the base rate only or not available. Consequently, the estimate may exclude estimates for additional charges and payer payments for services billed in conjunction with the item or service you selected.
Also, this estimate DOES NOT include other services billed for separately by other providers including but not limited to physician or practitioner fees such as pathologist, radiologist, anesthesiologist, physician surgeon or assistant surgeon, etc.
Please click the link to assess the Price Estimator Tool for HHSC Regions listed below:
Please click the links to download Standard Charges for your desired facility:
Avoiding Surprises in Your Medical Bills: A Guide for Consumers
We believe patients and their families should be protected from the financial burdens of unexpected medical bills. Learn more in this notice designed to help consumers understand the questions they can ask to help avoid paying more than expected for health care services.