AHA: Hospitals may publish revenue codes included in the list of standard charges

Wednesday, December 19, 2018

Hospitals are allowed to publish a list of charges that contains UB-04 revenue codes when complying with 2019 IPPS final rule requirements requiring the publication of standard charges, the American Hospital Association (AHA) said in a regulatory advisory bulletin released December 11.

However, hospitals that choose publish revenue codes that are included in their list of charges are required to post the AHA’s copyright notice, which can be downloaded here.

The 2019 IPPS final rule requires hospitals to post a list of their standard charges online in a machine-readable format. CMS enacted the requirement, which goes into effect January 1, 2019, to encourage price transparency and assist with patients’ financial planning. The requirement has been controversial since it was first put forward in the 2019 IPPS proposed rule in June. Following the publication of the final rule in August, CMS released additional guidance and clarification for hospitals in an October FAQ and a follow-up FAQ released December 4.

The AHA’s advisory bulletin recaps information included in the two FAQs, including CMS’ definition of machine-readable format, potential enforcement mechanisms, and the additional requirement that hospitals make public their standard charges for each diagnosis-related group.

The bulletin also includes information from the AMA on the use of CPT® codes. Hospitals that have a current, valid CPT license for their chargemaster are permitted to post that information for the purposes of complying with the IPPS final rule. Hospitals that do not have a current, valid CPT license can contact the AMA here.

Hospitals are encouraged to contact the AHA at ub04@aha.org for questions regarding UB-04 revenue code licensing.

This article was originally published on Revenue Cycle Advisor.