Hospital Price Transparency Requirements

CY 2020 Hospital Outpatient Prospective Payment System Policy Changes

On November 15, CMS finalized policies that lay the foundation for a patient-driven health care system by making prices for items and services provided by all hospitals in the United States more transparent for patients so that they can be more informed about what they might pay for hospital items and services.

The policies in the final rule will further advance the agency’s commitment to increasing price transparency. It includes requirements that would apply to each hospital operating in the United States. In response to comments, CMS is extending the effective date to January 1, 2021 to ensure hospital compliance with these regulations.

The final rule includes:

Definitions of “hospital,” “standard charges,” and “items and services”
Requirements for making public all standard charges for all items and services in a machine-readable format
Requirements for displaying shoppable services in a consumer-friendly manner.
Monitoring and enforcement

For More Information:

View the final rule (CMS-1717-F2): This HHS‐approved document has been submitted to the Office of the Federal Register (OFR) for publication and has not yet been placed on public display or published in the Federal Register. The document may vary slightly from the published document if minor editorial changes have been made during the OFR review process. The document published in the Federal Register is the official HHS‐approved document.
Press Release.
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See the full text of this excerpted CMS Fact Sheet (Issued November 15).

View this edition as a PDF (PDF)

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