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Hospital Charges

Beginning January 1, 2019, the U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services are requiring hospitals and health systems to post their current, standard charges.

In accordance with federal requirements, Capital Health provides information on its standard list of hospital charges. Charges are not the same as prices; charges are like a sticker price that is negotiated down for virtually all health care customers. They are contained in a large report called a chargemaster. Click here to view our chargemaster. For example, charge code 5471250 with the description “Diagnostic Imaging – CT Scan of Chest” lists the charge as $14,350. Capital Health is then paid approximately $114. Our goal is for our consumers to have a full understanding of their medical expenses.

Hospital charges are the amount a hospital bills an insurer for a service. For most patients, hospitals are reimbursed at a level well below charges. Patients covered by commercial insurance products have negotiated rates with hospitals. Patients covered by Medicare or Medicaid programs have hospital reimbursement rates determined by federal and state governments.

Hospital charges may include bundled procedures, personnel, services, facilities and supplies. An example would be room rates that include the space, equipment, nursing personnel and supplies.

As a patient, you have the opportunity to shop for medical services. If you are considering care at Capital Health, you should first contact your insurance carrier to understand which costs will be covered and which costs will be your responsibility.

If you are a patient at Capital Health or a prospective patient and have questions related to our charges, please call our Patient Accounts Department at 609-394-6023 or email [email protected] Be sure to provide your contact information and the charges if you are leaving a message.