New CMS transparency rules: 3 things to know

CMS has been phasing in new hospital price transparency requirements throughout 2024, with more changes set to take effect Jan. 1, 2025.

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Here are three things to know about the upcoming legislative updates:

1. Starting in 2025, hospitals and other stakeholders must provide  additional data elements to increase transparency.

2. Among the additional data are  “estimated allowed amount,” “drug unit of measurement” and “modifiers.”

3. The “estimated allowed amount” refers to the average dollar amount a hospital historically receives for an item or service, according to a Pharmacy Times report published Sept. 6. This data must now be included in machine-readable files.

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