Medicare Procedure Price Lookup

Allows Patients to Compare Cost between ASC and HOPDs

The 21st Century Cures Act, signed into law on December 13, 2016, mandated CMS to develop a tool allowing the public to compare costs between HOPDs and ASCs.   In November of 2018,  CMS launched a new online tool, the Procedure Price Lookup.  This unique consumer service allows users to compare Medicare payments and copayments for certain procedures that are performed in both hospital outpatient departments (HOPDs) and ASCs. The Procedure Price Lookup tool displays national averages for the amount Medicare pays HOPDs and ASCs and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.

In addition, the tool includes an outpatient facility checklist that can help patients determine which facility is best for their outpatient procedures.  The checklist includes good questions that should provide education and allow patients to feel more confident about their healthcare decisions.  The site also links to hospital and ASC look-up tools which allow patients to find outpatient surgical facilities in their community.