Daily report
§180.50(a)(3)Attestation and responsible official
The price file has to say that the hospital stands behind it: a statement that the information is true, accurate and complete, and the name of the person responsible for it.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF correctly encodes the accuracy and completeness attestation | 85% | 3% | 11% | 1% | 0% |
| MRF correctly encodes the attester's name | 86% | 3% | 11% | 1% | 0% |
§180.50(b)(2)(i)Hospital and MRF information
The price file has to identify the hospital it belongs to, including its National Provider Identifier, and say which version of the CMS template it follows and when it was last updated.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF declares this hospital's Type 2 NPI | 71% | 0% | 11% | 17% | 0% |
| MRF correctly encodes its template version and update date | 85% | 3% | 11% | 1% | 0% |
§180.50(b)(2)(ii)Standard charges
The price file has to list the hospital's standard charges for each item and service: the gross charge, the discounted cash price, the rate negotiated with each insurer and plan and how it was set, and the lowest and highest negotiated rates. A rate given as a percentage or formula needs enough information to work out the dollar amount, and some rates need figures on the amounts actually paid.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF lists a gross charge for every item and service | 0% | 1% | 12% | 1% | 86% |
| MRF lists a discounted cash price for every item and service that has one | 0% | 0% | 12% | 1% | 88% |
| MRF correctly encodes the de-identified minimum negotiated charge | 81% | <1% | 14% | 1% | 4% |
| MRF correctly encodes the de-identified maximum negotiated charge | 81% | <1% | 14% | 1% | 4% |
| MRF correctly encodes payer and plan names | 85% | 0% | 14% | 1% | 0% |
| MRF correctly encodes how each charge was established | 85% | <1% | 14% | 1% | 0% |
| MRF expresses each negotiated rate as a dollar amount, percentage, or algorithm | 85% | <1% | 14% | 1% | 0% |
| Percentage and algorithm rates give enough information to derive a dollar amount | 0% | 0% | 12% | 67% | 21% |
| MRF correctly encodes the 10th percentile allowed amount | 56% | 1% | 12% | 1% | 30% |
| MRF correctly encodes the median allowed amount | 56% | 1% | 12% | 1% | 30% |
| MRF correctly encodes the 90th percentile allowed amount | 56% | 1% | 12% | 1% | 30% |
| MRF correctly encodes the count of allowed amounts | 65% | 2% | 12% | 1% | 21% |
§180.50(b)(2)(iii)Item and service information
Each item or service in the price file needs a description, whether it is provided as an inpatient or outpatient, and, for drugs, the unit and type of measurement.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF correctly encodes each item or service description | 85% | <1% | 14% | 1% | 0% |
| MRF correctly encodes the inpatient or outpatient setting | 85% | <1% | 14% | 1% | 0% |
| MRF correctly encodes drug units and measurement type | 55% | <1% | 12% | 1% | 32% |
§180.50(b)(2)(iv)Billing and coding information
Each item or service needs the billing codes a hospital uses for it, such as CPT, HCPCS, DRG or NDC codes, the type of each code, and any modifiers that change its price.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF correctly encodes billing codes and code types | 85% | <1% | 14% | 1% | 0% |
| MRF lists every applicable modifier and its charges | 0% | 0% | 12% | 1% | 88% |
§180.50(c)(2)CMS file format
The price file has to follow the layout CMS publishes, so anyone can read it with the same tools. Care Carta runs CMS's own validator on it.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF passes the CMS validator without errors | 84% | 4% | 11% | 1% | 0% |
§180.50(d)(1)-(6)Publication and accessibility
The price file has to be easy to find and free to get: published on the hospital's website without payment, an account, or personal information, readable by automated tools, a CSV or JSON file named the way CMS asks, listed in a cms-hpt.txt file on the website, and linked from the homepage as "Price Transparency".
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF downloads without payment | 89% | 0% | 0% | 11% | 0% |
| MRF downloads without an account or password | 89% | 0% | 0% | 11% | 0% |
| MRF downloads without submitting personal information | 89% | 0% | 0% | 11% | 0% |
| MRF downloads to an automated client | 89% | 10% | 0% | <1% | 0% |
| MRF is a CSV or JSON file, optionally compressed | 89% | 1% | 10% | <1% | 0% |
| MRF file name follows the CMS convention | 81% | 9% | 10% | <1% | 0% |
| cms-hpt.txt is published and uses the required fields | 70% | 3% | 0% | 27% | 0% |
| cms-hpt.txt links this hospital's MRF | 73% | 0% | 0% | 27% | 0% |
| Homepage has a link labelled Price Transparency | 80% | 1% | 0% | 19% | 0% |
§180.50(e)Update frequency
The price file has to be updated at least once a year.
| Check | Passed | Failed | Blocked | Couldn't determine | Not assessed |
|---|---|---|---|---|---|
| MRF was updated within the past 12 months | 86% | 3% | 11% | 1% | 0% |
Understand these numbers
The bar shows each hospital's result for the whole section, the same result its own page shows; a hospital with several price files counts once, with the most serious result across them. The percentages beside each check are shares of every hospital whose file we checked; not assessedincludes the few checks that don't apply to a hospital's file. Couldn't determine is never counted against a hospital, and not assessed means the check can't be made from the price file alone, or isn't built yet. See what the results mean.
The summaries above are plain-language descriptions of what Care Carta checks, not the rule's text. Read the rule itself for its exact requirements.