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  5. /Case rate
CPT G0294

Non-cov proc- clinical trial

Reported by 26 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$25

Average

$521

Median

$39

High

$3.9k

Hospitals reporting this code

#HospitalLocation
1Virginia Mason Medical CenterSeattle, WA$30$44$1.2k$18.7k$4.5k
2IHC Health Services Inc., DBA Intermountain Health Intermountain Medical CenterMurray, UT$38$38$39$44$2
3IHC Health Services Inc., DBA Intermountain Health Utah Valley HospitalProvo, UT$31$38$37$43$4
4IHC Health Services Inc., DBA Intermountain Health McKay-Dee HospitalOgden, UT$32$37$38$42$3
5IHC Health Services Inc., DBA Intermountain Health St George Regional HospitalSt. George, UT$37$38$39$42$2
6IHC Health Services Inc., DBA Intermountain Health LDS HospitalSalt Lake City, UT$37$37$39$43$2
7Scl Health - Montana, Dba Intermountain Health St. Vincent HealthcareBillings, MT$39$75$70$108$25
8Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$39$2.5k$3.9k$7.6k$3.6k
9IHC Health Services Inc., DBA Intermountain Health Logan Regional HospitalLogan, UT$32$37$38$41$3
10St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional HospitalJUNCTION, CO$39$39$40$41$0
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