In April, Gov. John Hickenlooper signed into law a bill sponsored by Sens. Irene Aguilar and Kevin Lundberg regarding the transparency of medical costs provided to patients by health care providers and facilities after it was passed by the Colorado legislature. Effective Jan. 1, 2018, the Transparency in Health Care Prices Act (SB 17-065) requires health care providers and facilities to disclose the charges for common health care services when a patient’s payment is made directly rather than by a third party, such as an insurance company.

Disclosure is required for the following charges:

  1. The 15 most common health care services the provider offers.
  2. The 50 most used diagnostic-related group codes for in-patient health care services.
  3. The 25 most used out-patient CPT codes (or codes used by the specific billing system).

The amount posted publicly does not include charges for complications or exceptional treatment. Additionally, health care providers and facilities are not required to report their prices to any government agency for review or approval.

The full text of the bill can be viewed here.

If you have any questions or need guidance, please call Caplan and Earnest at 303-443-8010.