Hospital price transparency file review
File reviewed 123456789_example-regional-medical-center_standardcharges.json
The file doesn't meet 1 CMS requirement that this review checks.
How this file compares with the other 129 Georgia hospitals whose files Percentry reviewed on the same date. Lower is better on every measure. No other hospital is named.
| Measure | This hospital | Georgia median | Share of Georgia hospitals that do better |
|---|---|---|---|
| CMS requirements not met Distinct CMS requirements the file (or how it's posted) doesn't meet. | 1 | 0 | 92% do better |
| Likely-inaccurate data Distinct kinds of data that are probably wrong or inconsistent. | 2 | 1 | 65% do better |
| Access problems Problems finding or downloading the file: cms-hpt.txt, links, naming, blocked downloads. | – | 0 | Not applicable |
| Percentage/algorithm rates reporting zero payments Share of those rates with a count of allowed amounts of "0" (hospitals with 100+ such rates). | 89% | 93% | 34% do better |
| Months since the file was updated From the file's last_updated_on date. CMS requires an update at least every 12 months. | 7 | 6 | 72% do better |
Each row is a problem this review looks for, based on the CMS v3 data dictionary and 45 CFR 180.50. A ✓ means the file doesn't have it.
| ✓ | Schema version is not 3.xHPT-F01 | Not found |
| ✓ | Attestation text doesn't match the CMS wordingHPT-F02 | Not found |
| ✓ | Attestation is not confirmedHPT-F03 | Not found |
| ✓ | No attester namedHPT-F04 | Not found |
| ✓ | Type 2 NPI missing or invalidHPT-F05 | Not found |
| ✓ | File is more than 12 months old (or has no valid date)HPT-F07 | Not found |
| ✓ | Required CSV column missingHPT-F08 | Not found |
| ✓ | CSV row has a different number of columns than its headerHPT-F09 | Not found |
| ✓ | Required general data element missing or blankHPT-F11 | Not found |
| ✓ | Column header still contains a CMS template placeholderHPT-F12 | Not found |
| ✗ | Methodology "other" without an explanationHPT-C1 | Found |
| ✓ | Item with no charge of any kindHPT-C2 | Not found |
| ✓ | Payer rate with no dollar, percentage, or algorithmHPT-C3 | Not found |
| ✓ | Negotiated dollar without de-identified minimum/maximumHPT-C4 | Not found |
| ✓ | Percentage/algorithm rate without a count of allowed amountsHPT-C5 | Not found |
| ✓ | Percentage/algorithm rate missing allowed-amount percentilesHPT-C6 | Not found |
| ✓ | Count of "0" without an explanationHPT-C7 | Not found |
| ✓ | NDC code without drug unit and typeHPT-C8 | Not found |
| ✓ | Negotiated charge without a payer name, plan name, or methodologyHPT-C9 | Not found |
| ✓ | Code without a code type (or a type without a code)HPT-C10 | Not found |
| ✓ | Standard charge without any code and code typeHPT-C11 | Not found |
| ✓ | Drug unit without a drug type (or a type without a unit)HPT-C12 | Not found |
| ✓ | Modifier row without a description, or without any charge or noteHPT-C13 | Not found |
| ✓ | Invalid code typeHPT-V1 | Not found |
| ✓ | Invalid settingHPT-V2 | Not found |
| ✓ | Invalid methodologyHPT-V3 | Not found |
| ✓ | Invalid count of allowed amountsHPT-V4 | Not found |
| ✓ | Numeric value that isn't a positive numberHPT-V5 | Not found |
| ✓ | Invalid drug type of measurementHPT-V6 | Not found |
Why it matters: CMS conditional requirement: "other" needs a description of the arrangement in the payer-specific or generic notes.
What to do: Describe the "other" arrangement in the payer-specific notes (or the generic notes).
Why it matters: license_number should be the state hospital license number, or omitted if there is none.
What to do: Enter the state hospital license number, or leave it blank if the state doesn't issue one (keep the state code).
Found 32 times.
Why it matters: The de-identified minimum and maximum should be the lowest and highest negotiated dollar amounts for the item.
What to do: Recompute each item's minimum and maximum from its negotiated dollar amounts.
Found 30 times.
Why it matters: Hospitals with an ED bill these services constantly; verify the count against 835 data.
What to do: Re-check the count against 835 remittances. Services like ED visits and CT scans are rarely unpaid for a whole year.
Since January 1, 2026, every payer rate expressed as a percentage or an algorithm must come with the count of allowed amounts and, unless the count is "0", the median, 10th, and 90th percentile allowed amounts, all calculated from 835 remittance data.
Counts as encoded across all payer rates that give one (some files add counts to dollar rates too):
| Count of allowed amounts | Rates |
|---|---|
| 0 | 336 |
| 1 through 10 | 42 |
| 11-49 | 1 |
What was reviewed. The hospital's public machine-readable file, 123456789_example-regional-medical-center_standardcharges.json (JSON, version 3.0.0), with 126 items, 126 standard charges, and 757 payer rates across 3 payers and 7 plans. File fingerprint (SHA-256): f11ada943bc0d9715df69a6990bb0108870ab9378c6e31b7104067e497b8d7fc.
How. This review checks the file against the CMS v3 data dictionaries (JSON and CSV) and 45 CFR 180.50, and goes further with accuracy checks. In testing on 133 hospital files, it caught every type of error CMS's own validator reported. 66 checks in all; each finding above names its rule.
Limits. This review covers only what the file and website show. It doesn't see the hospital's contracts, chargemaster, or 835 remittances, so it can't confirm that a rate or count is correct, only that it's complete, consistent, and plausible. Findings marked "To verify" need that internal check. This review is not legal advice.