Rationale and Objectives
In 2019, Centers for Medicare and Medicaid Services enforced regulation from the Affordable
Care Act, requiring all U.S. hospitals to publish standard hospital charges annually.
This study assesses top U.S academic hospitals’ chargemasters for selected advanced
diagnostic imaging services and the usability of publicly available information to
allow consumers to determine out-of-pocket costs.
Materials and Methods
Publicly available chargemasters and associated websites for the top 20 ranked hospitals
in U.S. News and World Report were assessed for several features including: file format,
inclusion of CPT codes, disclaimers on charges versus costs and professional fees,
and tools allowing determination of actual out-of-pocket costs for selected advanced
diagnostic imaging examinations.
Results
All hospitals had publicly available chargemasters, 90% of which were in Microsoft
Excel format. Ten percent of chargemasters included CPT codes. All chargemaster websites
had disclaimers regarding differences between charges versus patient costs; 20% had
disclaimers regarding professional fees. 20% of hospitals provided out-of-pocket costs
for uninsured patients or tools allowing out-of-pocket cost determination. Median
(range) MR exam charges were: brain with and without contrast: $5375 ($834–$13,857),
noncontrast knee: $3402 (4530–$6924); noncontrast lumbar spine: $ 3449 ($473–$7367).
Median (range) CT exam charges were: noncontrast head: $1923 ($165–$4974), noncontrast
chest: $1947 ($282–$2991); contrast abdomen/pelvis: $4307 ($486–$11,726).
Conclusion
While all top-ranked hospitals had publicly available chargemasters, they rarely provided
transparent information to allow patients to determine out-of-pocket costs for advanced
diagnostic imaging services.
Key Words
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Article Info
Publication History
Published online: January 31, 2020
Accepted:
November 27,
2019
Received in revised form:
November 27,
2019
Received:
October 22,
2019
Identification
Copyright
© 2019 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
