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CMS Releases Price Comparison Tool for Certain Surgical Procedures

November 30, 2018

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PRESS CONTACTS
Mary Mullaney, Director, Hospital Payment Policies

The Centers for Medicare and Medicaid Services (CMS) Nov. 27 released an online price comparison tool to allow beneficiaries to compare Medicare payments for certain procedures that are performed in both hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs).

The tool, the Procedure Price Lookup, was mandated by Congress in the 21st Century Cures Act (P.L. 114-255) to facilitate price transparency for items and services furnished in an HOPD or an ASC.

Medicare statutes require that CMS maintain separate payment systems for different types of health care providers, meaning both CMS and patients may pay different amounts for the same service, depending on the site of care.

Of note, the tool does not take into account complexity of the case or a patient’s health status, which could be a reason for choosing an OPD rather than an ASC.

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