Hospital Charges

When you see a hospital charges an average of 2.5 .Medicare, did you know there are 5 pay rates?

Independent ambulatory surgery centers ASCs and PCPs only get 1/3 to 1/2 system owned clinics and remote surgery centers. But charges (retail we are billed for by system owned) can be 4x , 8x or unlimited x —even though they don’t expect to get that? “Chargemaster” rates are considered a trade secret but are how much every hospital marks up Medicare rates to bill us and our insurance.

When you read the AHA – the hospital lobby- sued POTUS to fight transparency mandates by Executive Orders, it revolves around these types of secrets.

Excerpt

CPT codeCurrent rateProposed
99201 (Level 1)$45$44
99202 (Level 2)$76$135
99203 (Level 3)$110$135
99204 (Level 4)$165$135
99205 (Level 5)$211$135