For COVID or Monkeypox testing, make an appointment at an Urgent Care location, visit hhs.gov or visit the Georgia Department of Public Health website.
You can also schedule a COVID test appointment at any Piedmont QuickCare location. If you have a medical emergency, visit one of our Emergency Departments.

Hospital Price Transparency

Piedmont Healthcare is committed to empowering our patients, in partnership with their care team, to make informed decisions about their healthcare. This includes helping our patients understand the cost of their care, as well as financial assistance that may be available.
 

Price Estimation Tool

Piedmont Healthcare is committed to empowering our patients, in partnership with their care team, to make informed decisions about their healthcare. This includes helping our patients understand the cost of their care, as well as financial assistance that may be available.

As part of this commitment, we provide patients (and potential patients) an online tool to estimate their out-of-pocket costs for common medical procedures and tests. Our online tool calculates the out-of-pocket hospital costs based on the selected procedure and a patient’s insurance information. The online tool can also be used to estimate cost for patients that do not have health insurance coverage.

At Piedmont, we understand that healthcare costs can be very confusing, and we want to ensure our patients understand potential costs as clearly as possible. In addition to utilizing our online estimation tool, we encourage patients to contact us at 1-855-788-1212. Our Patient Financial Care team is standing by to educate patients regarding costs and billing.

It’s important to understand the online tool only provides an estimate and is not a guarantee of total costs. Please review the disclaimers in detail before using the tool.

Access the Price Estimator Tool

 

List of Standard Charges

In compliance with the Centers for Medicare and Medicaid Services (CMS) Hospital Price Transparency regulations, Piedmont provides a list of standard charges in a machine-readable format. The public may view these requirements at the following CMS webpage: cms.gov/hospital-price-transparency.

The charges posted on our website are accurate, with applicable disclaimers, as of the dates indicated within the files. CMS requires hospitals to update annually. Therefore, ongoing additions and changes may not be reflected in the posted files.

The listed charge of a hospital service is not equivalent to the actual amount paid by governmental or commercial insurance companies.  Accordingly, each patient’s financial responsibility may vary. The amount a patient pays is based on many factors, including health insurance provider, specific benefit plans and other applicable discounts, as well as the services provided based on each patient’s unique needs.

Piedmont reviews its hospital charges annually to ensure they accurately reflect the high-quality care we seek to provide. In some cases, our charges are different from other providers when we offer a differing level of care or unique clinical expertise. Overall, Piedmont works with patients, providers and partners to lower the cost of care through wellness programs, disease management and quality care.

 

Disclaimer

The comprehensive, machine-readable files below are posted to comply with federal regulations. Due to the nature of the files, they will likely be of limited utility to any specific patient.

To best understand your estimated out-of-pocket costs, it’s important for you to understand your insurance plan benefits and coverage before seeking medical care. Any amount not covered by your plan becomes your financial responsibility or the responsibility of a guarantor (such as a parent of a minor child).

The self-service Price Estimation Tool can help you and other consumers obtain cost estimates for many common services provided by Piedmont hospitals. For more specific cost estimates, please call 1-855-788-1212, to speak with a representative from our Patient Financial Care team.

To obtain the most accurate estimate, please consult with your physician to obtain the procedure codes that will be related to your treatment. This information will allow Piedmont to provide you with a service-specific hospital price estimate based on your individual circumstances and patient responsibility.

Piedmont Healthcare is using Epic’s standard output as the content for most of the facility-specific machine-readable standard charges files. Epic is a third-party information system for patient billing, which houses payer contract information.

Due to limitations in presenting complicated and differing contracted rate methodologies in a standardized way, the contracted rate (i.e., payer-specific negotiated charges) in the machine-readable files may not always reflect the contracted rate that applies in an individual patient’s case.

There are several potential variables that exist by patient and/or health insurance plan that must be considered to arrive at contracted rates applicable for specific items and services. Please read below for an explanation of each of the differing variables.

If there is a discrepancy between a payer-specific negotiated charge listed in the machine-readable file(s) and the contracted rate applicable to a specific patient claim, the terms of the payer contract will control, so the machine-readable file(s) may be of limited benefit to our patients. We recommend Piedmont patients use our Price Estimation tool for personalized cost estimates for Piedmont hospital services.

Accessing any of these posted files constitutes your agreement that you have read the above content and any additional supplementary disclaimers contained below.

Examples of potential contracted rate differences include but are not limited to the following:

 

DRG Reimbursement

Some payers base rates on diagnosis related group (DRG) reimbursement with additional payment terms. In some cases, a payer-specific negotiated charge provided in the machine-readable file(s) may not always be applicable to an individual case due to differences in negotiated rate methodology that depend on the mix of items and services on a claim. Epic’s calculation methodology reflects rates based on a median patient account for each DRG and may not factor in all applicable contract terms.

For example, differences in length of stay and calculation methods may result in a payment rate for some patient claims that vary from the payer-specific negotiated charges reflected in the machine-readable file(s).

Furthermore, because of Epic’s logic, the median account chosen to represent the historical gross charge may be a different median account chosen to represent the payer-specific negotiated rate. This may lead to a situation where the negotiated rate looks to be higher than the gross charge when, in reality, the negotiated rate is typically capped at billed charges.

Per Diem Rates

Per diem rates in the machine-readable file(s) were calculated based on the length of stay for the median account. Rates in an individual case will depend on the patient’s actual length of stay.

Medicare Reimbursement Methodology

For Medicare Advantage health insurance plans and payer rates based on Medicare methodology, contracted rates in the machine-readable file(s) may not reflect the rate applicable to every individual case, because Epic’s methodology calculates the contracted rate without factoring in service location, provider group, rate hierarchy and other pricing calculations applicable to Medicare payment methodologies.

Medicare rates are typically updated annually on October 1, for inpatient rate updates, and January 1, for outpatient rate updates. Medicare may make retrospective rate changes that are not reflected in the machine-readable file(s) because the file was created before Piedmont Healthcare received notification of the rate change.

Please consult publicly available Medicare rates for additional rate information.

Varying Rate Terms

Some payer contracts have varying rate methodologies. In some cases, a payer-specific negotiated charge provided in the machine-readable file(s) may not be applicable to an individual case due to differences in negotiated rate methodology that depend on the mix of services on a claim. Differences in service type and location could affect the rates that apply in an individual case.

Negotiated Charges Based on Age Category

Some payers have negotiated charges that are based on age category (for example, adult and pediatric). Epic calculates the contracted rate in the machine-readable file(s) based on a single median account. Rates in the machine-readable file(s) may be calculated based on an adult or a pediatric case.

Multiple Procedure Reductions

If more than one procedure is performed during a single visit, the contracted rate for the secondary and subsequent procedures could be lower than a single procedure rate, depending on the payer contract terms. The machine-readable file(s) contains the single procedure rate, which may be higher than any applicable multiple procedure rate.

Hierarchy

When a payer contract has multiple negotiated rate methodologies, the contracted rate for some services can take precedence over rates for other services, depending on the mix of services on a claim. The machine-readable file(s) will reflect the contracted rate for a single service, which may be different from the actual rate if multiple services are provided to an individual.

Contract Exclusion Terms

In some cases, payer contracts may have additional reimbursement for implantable devices and/or high cost pharmacy charges. These exclusions may result in additional reimbursement to the negotiated case rate or per diem, and will be calculated on a case by case basis depending on account detail. The machine-readable file(s) will reflect the contracted rate for a single service, which may be different from the actual rate plus exclusion reimbursement on an individual account.

Physician and Advanced Practice Provider Professional Services

When multiple services are billed during a single visit to a physician or advanced practice provider, contracted rates for the secondary and subsequent services could be reduced, depending on the contract terms/payer policies. Contracted rates in the machine-readable file are for physician services. The contracted rates are based on a single service and do not contain any discounting for multiple services. Contracted rates will also not reflect any discounts from physician rates which may be applicable to services performed by advanced practice providers, such as physician assistants and nurse practitioners.

 

Standard Charge Files

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