CMS unveils charges for outpatient hospital procedures

ModernHealthcare.com
June 5, 2013

Less than a month after the CMS released data on what hospitals charge for inpatient procedures, the agency has released similar information about the prices hospitals submit and are paid on the outpatient side.

The greater transparency comes as hospitals have pushed back against the initiative, arguing that the data isn't meaningful to consumers because of the gulf between what hospitals charge and the bottom line for patients.

HHS Secretary Kathleen Sebelius unveiled the calendar year 2011 data on Monday as part of Health Datapalooza IV, an annual conference on data transparency. In addition to the pricing information for 30 hospital outpatient procedures, the CMS released county-level data on Medicare expenditures and the different brands of electronic health records being adopted.

As with inpatient services, hospital charges ran the gamut. For instance, Fort Walton Medical Center, Pensacola, Fla., charged $32,105.64 in 2011 for a level IV upper airway endoscopy. The 257-bed hospital, part of publicly traded HCA, was reimbursed an average of $1,396.45.

Yet for the same procedure, 98-bed Park Ridge Health, Hendersonville, N.C., part of Adventist Health System, charged $1,527.95, find out how much they were reimbursed by clicking here.