The Hospital Price Transparency rule went into effect on January 1, 2021.

Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it. Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways:

1. As a comprehensive machine-readable file with all items and services.
2. In a display of shoppable services in a consumer-friendly format.

Austin Emergency Center does not provide shoppable services. Our locations are freestanding emergency medical care facilities, and do not offer hospital-based outpatient services you can schedule in advance. A shoppable service means a service that can be scheduled by a healthcare consumer in advance. Procedures such as joint replacements and services such as physical therapy are examples of shoppable services.

---

Standard Charge Files

The Centers for Medicare and Medicaid Services (CMS) requires that hospitals make available a Standard Charge File for consumers to review that includes the five different types of charges defined below. Our hospital Standard Charge file includes information from our charge master and payer negotiated agreements but they do not reflect a patient’s liability. If you have insurance coverage, we encourage you to contact your insurance provider to discuss patient payment obligations as defined under your insurance plan. 

What Are Standard Charges?

1. Gross Charge: The full price listed on the hospital chargemaster. Gross charges can vary from hospital to hospital for the same procedure or service based on factors like hospital location, physician supply and medication preferences, the kinds of services the facility typically provides, and the expertise required to deliver the services.
2. Discounted Cash Price: The price offered to patients who pay on their own without third-party insurance coverage.
3. Payer-Specific Negotiated Charge: The charge a hospital has negotiated with a third-party payer for an item or service, which can vary based on your coverage and specific plan. You’ll sometimes see this referred to as the “allowed amount” on an insurer’s EOB.
4. De-identified Minimum Negotiated Charge: The lowest charge a hospital has negotiated for an item or service across all insurers.
5. De-identified Maximum Negotiated Charge: The highest charge a hospital has negotiated for an item or service across all insurers.

Standard Charge File Notes

• The hospital charges listed do not include patient-specific insurance deductibles or copayments, potential self-pay, or financial assistance discounts and therefore are not a reflection of patient responsibility.
• The pricing is in effect as of the applicable period prior to the publication date; pricing is subject to change. Any changes to charges, rates, network participation, or other data elements on or after the publication date are not reflected.
• Actual reimbursement for services is dependent on many factors, such as the length of stay, the specific medical services provided, the medications and supplies provided with the service, and other variable factors that vary by payer and pricing methodology.
• Comparisons of rates within the file between payers or comparison of files between hospitals will not necessarily reflect accurate distinctions in prices due to variations in pricing methodology.
• Pricing does not include charges for all physician services or other ancillary professional services that may be rendered.
• Not all services listed in this file may be currently available at the hospital.

---

No Surprises Help Desk

• 800-985-3059
• cms.gov/nosurprises/consumers

Texas Department of Insurance Help Line 800-252-3439