Hospital Price Transparency

Hospital Price Transparency

This information will make it easier for consumers to shop and compare prices across hospitals and estimate the cost of care before going to the hospital.

header-title-decorationHospital Price Transparency

Current regulations require hospitals to publish certain information about standard charges. Those hospitals are required to provide the information in two ways:

    1. A comprehensive machine-readable file for all items and services
    2. A consumer-friendly display for 300 shoppable services

The following resources are our effort to comply with those regulations. We hope they help patients and families make more informed decision about their care.  That said, the cost of care differs from individual to individual. Therefore, none of the rate information provided here reflects the cost of service provided to any specific individual.

Because the information here is general, we encourage patients to find out more about their own costs before getting care. Patients with insurance coverage should contact their insurance plans directly—as private coverage typically require co-payments or co-insurance—none of which are provided here. Furthermore, the regulation does not require that we disclose fee-for-service rates associated with Medicare or Medi-Cal.

Health Services’ rates are set up differently than those in many other health systems. Generally, we charge bundled (per-day or per visit) rates, rather than use per item or service rates as other hospitals do. Because there is not a one-to-one correlation between an item or service and a rate, some of our posted rates are estimates based on a standard course of treatment within our system. In addition, because we are a county safety net system, some of our rates are available only to people who are residents of Los Angeles, uninsured or meet specific program criteria.

Here are some other things to know about the posted rates:

  • Many of the rates we disclose are negotiated with third party payors and are specific to region, hospital, service line or population.
  • Others come from our Board of Supervisor’s approved Charge Data Master—a collection of charges for certain products, procedures, and services sometimes called a “chargemaster.”
  • In many instances our rates vary by care setting; the same service provided in a more intensive health care setting (for example an emergency room) may cost more than the same service provided somewhere else (like a health clinic).
  • Rates may differ for different patients for a number of reasons such as the seriousness of the disease or condition, the patient’s type of health insurance or coverage, and whether the patient has an ability to pay for her or his care.
  • As mentioned above, Health Services usually charges payors per day, per visit, or for bundles of services rather than by item or by service. The rates provided here are estimates and we do not practice itemized billing on an individual basis.
  • None of the information we provide here constitutes an offer of items or services at any price.

For these and other reasons, price comparisons between Health Services’ rates and those of other health systems may be challenging.  Therefore, before scheduling any procedure or drawing any conclusions about what your service may cost, please contact the following:

LAC+USC Medical Center: (323) 409-6361

Harbor/UCLA Medical Center: (424) 306-7000

Olive View/UCLA Medical Center: (747) 210-3082

Rancho Los Amigos National Rehab. Center: (562) 385-7320

 

Machine Readable Files

The downloadable Machine Readable files below include the following for services rendered by Health Services’ hospitals.  For the reasons expressed above,  these rates do not necessarily reflect the amount a patient may ultimately pay:

    1. the gross charge for each service
    2. the hospital negotiated base rate
    3. the maximum and minimum payment rate
    4. the discounted cash price

LAC+USC Medical Center

Harbor-UCLA Medical Center

Olive View-UCLA Medical Center

Rancho Los Amigos National Rehabilitation Center

 

Consumer Shoppable Services

The consumer shoppable rates include the following information for 300 services commonly provided by Health Services’ hospitals, including seventy services specified by Centers for Medicare and Medicaid Services:

    1. the hospital negotiated base rate
    2. the maximum and minimum payment rate
    3. the discounted cash price

For the reasons expressed above, these rates also do not necessarily reflect the amount a patient may ultimately pay.

 

LAC+USC Medical Center

Shoppable Bundled Services – By Per Diem Rate

Shoppable Bundled Services – By Inpatient DRGs

Shoppable Outpatient Procedures – Medi-Cal Managed Care Contracts

Shoppable Outpatient Procedures – Medicare Hospital Contracts

Shoppable Outpatient Procedures – Medicare Physician Contracts

No-Cost/Low-Cost Programs (English and Spanish Versions)

 

Harbor-UCLA Medical Center

Shoppable Bundled Services – By Per Diem Rate

Shoppable Bundled Services – By Inpatient DRGs

Shoppable Outpatient Procedures – Medi-Cal Managed Care Contracts

Shoppable Outpatient Procedures – Medicare Hospital Contracts

Shoppable Outpatient Procedures – Medicare Physician Contracts

No-Cost/Low-Cost Programs (English and Spanish Versions)

 

Olive View-UCLA Medical Center

Shoppable Bundled Services – By Per Diem Rate

Shoppable Bundled Services – By Inpatient DRGs

Shoppable Outpatient Procedures – Medi-Cal Managed Care Contracts

Shoppable Outpatient Procedures – Medicare Hospital Contracts

Shoppable Outpatient Procedures – Medicare Physician Contracts

No-Cost/Low-Cost Programs (English and Spanish Versions)

 

Rancho Los Amigos National Rehabilitation Center

Shoppable Bundled Services – By Per Diem Rate

Shoppable Bundled Services – By Inpatient DRGs

Shoppable Outpatient Procedures – Medi-Cal Managed Care Contracts

Shoppable Outpatient Procedures – Medicare Hospital Contracts

Shoppable Outpatient Procedures – Medicare Physician Contracts

No-Cost/Low-Cost Programs (English and Spanish Versions)

 

Key Resources

  1. CMS FAQ for Hospital Price Transparency
  2. CMS Hospital Price Transparency final rule published 11/27/2019 Final Rule
  3. New Transparency in Coverage Final Rule Fact Sheet (issued Oct. 29, 2020)
  4. Medi-Cal Fee Schedule- professional and outpatient: https://files.medi-cal.ca.gov/Rates/rates_range_display.aspx
  5. Medi-Cal Fee Schedule inpatient: https://www.dhcs.ca.gov/provgovpart/Pages/DRG-Pricing-Resources-for-SFY-202021.aspx
  6. Medicare Physician Fee Schedule: https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx