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  5. /Case rate
HCPCS G8995

HC SUB PT/OT DISCH STATUS

Reported by 7 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

$130

Average

$141

Median

$143

High

$149

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1Catholic Health Initiatives ColoradoColorado Springs, CO$137$144$42—$72$606
2Catholic Health Initiatives ColoradoColorado Springs, CO$145$149$42—$72$606
3St Francis HospitalColorado Springs, CO$137$144$42—$72$220
4Longmont United HospitalLongmont, CO$152$142$53—$70$620
5Orthocolorado, LlcLakewood, CO$143$143$47—$70$220
6Catholic Health Initiatives ColoradoLakewood, CO$128$130$47—$64$606
7Catholic Health Iniatives ColoradoWestminster, CO$130$132$47—$64$606

Look up this code directly

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