Heath Care Pricing Transparency and Consumer Rights: Standard charges

Federal regulations require hospital-based health care providers to post standard charges in a Machine-Readable File (MRF). 

These files include gross charges (AKA the full price), discounted cash prices for patients not using insurance, payer-specific negotiated charges (allowed amounts negotiated by health insurance companies), and de-identified minimum and maximum negotiated charges (see detail). Prices are listed for each and every service, test, procedure, every disposable supply, etc. and are identified by CPT and HCPCS code.  A single code may show up in the database dozens of times because of the necessity to state the negotiated price with every insurance company as well as entries for the gross price, self-pay price, etc.

To find the MRF, go to any hospital's home page and add  “/cms-hpt.txt" at the end.  For example,

• Mercy Hospital -- https://www.mercy.net/cms-hpt.txt
• University of Missouri Hospital -- https://www.muhealth.org/cms-hpt.txt
• St. Lukes in Kansas City -- https://www.saintlukeskc.org/cms-hpt.txt

Next, note the URL location of the MRF (Machine Readable File)

location-name: Name of hospital system
source-page-url: Web address for page that contains a link to pricing data
mrf-url: Web address for machine-readable file containing price data
contact-name: Name of person designated to answer technical questions about the data file
contact-email: Email address of person designated to answer technical questions about the file

TIPS FOR ACCESSING A MACHINE READABLE FILE CONTAINING STANDARD CHARGES 

File can be enormous -- sometimes over 300 megabytes.  Files of this size fail to load in a browser and are too large for word processing programs. You can however open and search these files by following the suggested steps listed below.

Find the link to the MRF on a hospital website, then right-click on the file link and choose "Save link as..." to download to your device. Then, use a software program that is able to open and display it.  For Windows users, Notepad++ works well.  For Mac users, we've heard good things about BBEdit, available from the Apple Store.  After downloading the file and opening it in a software program, the next step will be to insert line breaks and spaces so it is easier to read.

• Instructions for Notepad++ 
  First, look closely at the file and notice where the “rows” (individual records) are supposed to begin and end.  Each record is enclosed by curly brackets and between each record there is a comma.  Here is a method to replace commas with line breaks: 
  • In the Search menu, select Replace. 
  • Enter “,” (without the quotes) in the “Find what:” box. 
  • Enter “\n” (without the quotes) in the “Replace with:” box. 
  • Change the radio button for the Search Mode from Normal to Extended. 
  • Then click on the Replace All button.
• Mac users
  You may find the TextEdit app which comes shipped with your Mac a suitable application for viewing Standard Charges files.  If however your machine slows and you see the spinning beachball, consider using a different software program such as BBEdit instead.