I don't think the information is publicly available. If doctors shared this information with each
other, they would be accused of price-fixing, which is a federal offence (never mind that they never
get to collect the usual and customary fee).
The payment system for hospitals and doctors is the most arcane thing known to man. No one really
understands it. And hospitals don't get paid according to their costs, but rather, whatever the
insurance companies pay. And their charges are not based in any type of reality either. In fact,
hospital accounting practices rarely even figure out what it costs to do something, because it
has absolutely nothing to do with how much they get paid, so knowing this does not affect their
bottom line.
Jeff
"Steve Wormuth" <[email hidden]> wrote in message "]news:[email hidden]...
Quoted message said:Hello,
I did a quick search and couldn't seem to locate the information I am seeking. I was wondering if
anyone could point me to a list of what a health insurer in New York would consider a "usual and
customary" charge. For instance, a hospital may charge $12.00 for an aspirin, but an
insurance
Quoted message said:adjuster may only pay $6.00 because that is the established "usual and customary" rate for an
aspirin.
Is this information available somewhere?
Steve
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