The Centers for Medicare & Medicaid Services (CMS) has launched a new online tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in hospital outpatient departments and ambulatory surgical centers. The Procedure Price Lookup tool displays national averages for the amount Medicare pays the hospital or ambulatory surgical center and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.
The launch of the Procedure Price Lookup tool is required by Congress in the 21st Century Cures Act. Medicare’s statutes require that CMS maintain separate payment systems for different types of healthcare providers, meaning CMS and patients may pay different amounts for the same service, depending on the site of care.
“The different payment rates are a prime example of Medicare’s misaligned financial incentives, under which providers can make more money if they see patients at one location as opposed to another,” CMS Administrator Seema Verma said.
CMS recently launched the eMedicare initiative to empower beneficiaries with cost and quality information. This announcement included the launch of an enhanced interactive online decision support feature to help people better understand and evaluate their Medicare coverage options. eMedicare also offers a mobile-optimized out-of-pocket cost calculator to provide beneficiaries with information on overall plan costs and prescription drug costs.
The Procedure Price Lookup tool is available at www.medicare.gov/procedure-price-lookup.