Erie County Medical Center is committed to pricing and billing transparency and has posted, in machine readable format, on our website; ECMCC’s Charge Master, a list of standard hospital charges for each service or item and a list of charges by Diagnostic Related Group (DRG). In addition, to assist the consumer we have provided a summary of the most frequently used charges along with the AMA CPT Code for services below.
ECMC’s charges are the same for all patients; however, a patient’s responsibility will vary depending on many factors. In addition to public programs such as Medicare and Medicaid, there are many health plans and employers that self-insure for employee health benefits. Each of these payers offer a range of coverage products and each coverage product can have a different definition of what is and is not covered, what the patient cost sharing (co-payments, deductibles or both) as well as payment methodologies and rules. There is no national standard set of requirements and rules; ECMC must follow each plan’s specific requirements. In addition, ECMC must comply with payers’ requirements for pre-authorization, admission notification, utilization review all of which impact the patients’ ultimate financial responsibility.
Recognizing that the list of standard charges and the charges by DRG may not provide the information you are seeking and to assist with your understanding and determining your unique financial responsibility, ECMC has established a dedicated point of contact. Patients can access this to obtain a price for any service by calling 716.898.3272 (8:00am – 4:00pm, M-F) or by email at priceinfo@ecmc.edu.
ECMCC maintains programs for patients that cannot afford to pay for services. These programs include a non-interest bearing loan program through a third party, a sliding fee schedule based on income and family size, grant programs for specific treatments, and a financial counseling team that will assist in these matters or enrollment in a government sponsored insurance program.
The charges reflected in the attached files and the summary reflect the fees for hospital services and not the services of professionals including physicians, nurse anesthetists and others. Consumers can expect a charge from a treating emergency room physician, an anesthesiologist or nurse anesthetist, a radiologist, a hospitalist physician, a psychiatrist among others.
For More Information
Download the ECMC Charge Master List
Download the Summary Pricing for Common MS-DRG Assignments
Frequently Asked Questions
What is a hospital chargemaster? Are the listed charges what I will pay for hospital services?
The chargemaster is a comprehensive standard price list for the services provided by the hospital (medical procedures, lab tests, supplies, medications, etc.). Because it represents the full range of services the hospital provides, there are thousands of items listed. The charges listed are generally not the amount a patient will pay. If you have health insurance, your out-of-pocket expenses will depend on the specific services you receive, your specific health insurance coverage, and your insurance company’s contract with the hospital. Please contact your insurance company for more information.
If you do not have health insurance, you may be eligible for insurance such as Medicaid, Essential Plans & Qualified Health Plans through the NYS Department of Health. You may also qualify for assistance through our Financial Assistance Program. Please contact our Financial Counseling Team at (716) 898-5566 for more information
Are charges the same for every patient?
Yes, hospital charges are standard for every patient, regardless of insurance status. The total charges on your patient bill will reflect the actual services that you receive, which may vary based on several factors, including your length of stay, the time it takes to complete your procedure, medications you receive, and other health conditions that could make your care more complicated.
In addition, your out-of-pocket expenses will depend on your specific insurance coverage and/or eligibility for discounted care based on the hospital’s Financial Assistance Policy.
How can I get an estimate of my out-of-pocket expenses for a procedure?
Patients with health insurance should contact their insurance company to get an estimate of their out-of-pocket expenses for a procedure. Patients without health insurance should contact The Patient Pricing Information Team at (716) 898-3272 or email priceinfo@ecmc.edu for an estimate as well as information about the hospital’s Financial Assistance Policy.
Can a patient receive charges for services that are not included in the chargemaster?
Yes, the hospital chargemaster reflects hospital services only and does not include any professional fees such as physician services that are billed separately. For estimated professional fees, please contact your physician’s office.
If insurance companies and patients without health insurance don't pay the chargemaster prices, what do they pay?
Insurance companies have contracts with the hospital for discounts from charges. In addition, patients with health insurance are responsible for certain cost-sharing requirements such as deductibles, copayments, and/or coinsurance that vary by insurance plan.
Patients without health insurance can apply for support through the hospital to either receive insurance coverage (if eligible) or reduced costs through the hospital’s Financial Assistance Policy. These programs will reduce the amount owed by the patient.
Why do charges for the same procedure or item vary by hospital?
Hospitals set their standard charges for services and items based on internal metrics, including the cost to provide patient care—which varies between hospitals. For example, charges will vary based on the location of the hospital, the availability of specialized services such as trauma and transplant services, whether it is a teaching hospital, its level of underpayment from the Medicare and Medicaid programs, and services provided to the uninsured. Again, these listed charges are generally not what insurance companies or patients without insurance ultimately pay.
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Erie County Medical Center Corporation (ECMCC) is not responsible for the content, privacy policy, accuracy or legality of any website accessed through a link on www.ecmc.edu. A link to another website does not constitute an endorsement, guarantee or approval by ECMCC of the linked website, or the information, products or services contained therein.