Prime Healthcare Services · Encino, CA
3 of 5
CMS star rating
148
Beds
1,536
Inpatient discharges a year
$56M
Net patient revenue a year
19
In-network payers
Encino Hospital Medical Center is a 148-bed proprietary hospital in Encino, CA, affiliated with Prime Healthcare Services. Below you'll find publicly disclosed negotiated rates and facility details, including 19 in-network payers and 47 disclosed rate categories.
The 24 services Encino Hospital Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Medicine & Surgery · Inpatient
MS-DRG 743
$11,983 - $17,102
from 2 insurers · median $14,542
Hospital reports inpatient surgical services to CMS
Medicine & Surgery
CPT 66984
$2,234 - $3,774
from 2 insurers · median $3,004
13 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
CT imaging
CPT 74177
$371 - $471
from 2 insurers · median $421
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$998 - $1,914
from 2 insurers · median $1,456
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$772 - $1,522
from 2 insurers · median $1,147
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$1,050 - $1,914
from 2 insurers · median $1,482
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$134 - $182
from 2 insurers · median $158
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45378
$817 - $1,521
from 2 insurers · median $1,169
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$244 - $262
from 2 insurers · median $253
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$8,379
negotiated rate
Typical for a hospital with this service line
CT imaging
CPT 71275
$224 - $396
from 2 insurers · median $310
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$180
negotiated rate
Common here, based on CMS Medicare volume
Urology
CPT 52000
$8,379
negotiated rate
Typical for a hospital with this service line
MRI imaging
CPT 70553
$379 - $447
from 2 insurers · median $413
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$749 - $1,011
from 2 insurers · median $880
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$44 - $76
from 2 insurers · median $60
Common here, based on CMS Medicare volume
MRI imaging
CPT 70551
$305 - $379
from 2 insurers · median $342
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93970
$279 - $390
from 2 insurers · median $335
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$305 - $379
from 2 insurers · median $342
Common here, based on CMS Medicare volume
Ultrasound
CPT 76856
$107 - $118
from 2 insurers · median $112
Common here, based on CMS Medicare volume
MRI imaging
CPT 73721
$305 - $379
from 2 insurers · median $342
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 64483
$674 - $1,446
from 2 insurers · median $1,060
Common here, based on CMS Medicare volume
Ultrasound
CPT 76830
$107 - $118
from 2 insurers · median $112
Common here, based on CMS Medicare volume
Gynecology
CPT 58563
$4,420 - $7,566
from 2 insurers · median $5,993
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 155% | 3 | 21 |
| Insurer B* | 21 | 102% | 0 | 21 |
How we chose these services: 1 appear in this hospital's own Medicare claims, 19 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Encino Hospital Medical Center, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
3 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$56M net patient revenue
Ownership and leadership
Owned by Prime Healthcare Foundation Inc
The employer identification numbers (EINs) health plans and networks list for Encino Hospital Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 26-2128507Prime Healthcare Services-Encino | 33Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), AmeriBen, Asuris Northwest Health, Avera Health Plans and 28 more | 1437322377 Prime Healthcare Services Encino LLC1083888663 Prime Healthcare Services - Encino LLC1629242201 Prime Healthcare Services - Encino LLCand 7 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
16237 Ventura Boulevard, Encino, CA 91436
(818) 995-5000
How Encino Hospital Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
3 of 5
Lower than 42% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
Better on 1 of 3 measures
1 better, 2 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
Better on 1 of 3 measures
1 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
No different on 4 measures
0 better, 4 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
1 of 5
The lowest rating, shared by 2% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
55%
Lower than 94% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.95
Lower than 57% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
134 min
Lower than 61% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
69%
Higher than 58% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 3 of 5 | |
| Death rates | Better on 1 of 3 measures | |
| Safety | Better on 1 of 3 measures | |
| Readmissions | No different on 4 measures | |
| Patient survey ratingCMS: Summary star rating | 1 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 55% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.95 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 134 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 69% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts Encino Hospital Medical Center's inpatient payments for its readmissions, quality and cost results.
-0.22% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+0.76% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for Encino Hospital Medical Center, beside the US median and the average of CA hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.075 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 409 cases | 3.3 | 3.9 | 3.81 | Better than 83% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.57 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.379 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 28 cases | 8.1 | 8.5 | 8.235 | Better than 59% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 77 cases | 10.8 | 11 | 10.29 | Better than 53% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 168 cases | 10.6 | 15.2 | 14.49 | Better than 98% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 11.57 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 1,023 cases | 0.29 | 0.51 | 0.4818 | No Different Than the National Rate | Better than 81% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 171 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 1,430 cases | 0.19 | 0.2 | 0.21 | No Different Than the National Rate | Better than 66% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 1,449 cases | 0.25 | 0.27 | 0.261 | No Different Than the National Rate | Better than 71% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 127 cases | 2.28 | 2.29 | 2.308 | No Different Than the National Rate | Better than 51% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.668 | Number of Cases Too Small | ||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 9.555 | Number of Cases Too Small | ||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 129 cases | 3.19 | 3.4 | 3.521 | No Different Than the National Rate | Better than 68% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.495 | Number of Cases Too Small | ||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.796 | Number of Cases Too Small | ||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 108 cases | 1.03 | 1.02 | 1.061 | No Different Than the National Rate | Worse than 52% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.09 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 88 cases | -8.6 | 1.25 | 7.901 | Better than 64% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 176 cases | 27.2 | 3.85 | 16.67 | Worse than 79% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 | Not Available | 12.91 | Number of Cases Too Small | ||
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.39 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.546 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 1.001 | Number of cases too small | ||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.43 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.19 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 37 cases | 20.3 | 19.8 | 19.94 | Worse than 69% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 75 cases | 20.7 | 21.3 | 21.41 | Better than 70% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.612 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 161 cases | 17.1 | 17.2 | 17.7 | Better than 54% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2347 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.834 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 761 | 1,370 | 5,722 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.544 | 0.9835 | 5.638 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.347 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5696 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2147 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.749 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 1,274 | 1,799 | 5,308 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.88 | 1.377 | 6.105 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.273 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5366 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.32 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.433 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 2 | 61 | 112 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.062 | 1.591 | 2.999 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.368 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.8107 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2606 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.273 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 73.49 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.6136 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.5911 | |||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.7863 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3103 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.305 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 13,184 | 14,451 | 52,601 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.489 | 0.567 | 3.111 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.166 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.7784 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1925 | Better than the National Benchmark | ||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.427 | 0.747 | 0.9502 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 13,184 | 13,646 | 48,317 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 7.019 | 5.683 | 27.04 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 0 | 2 | 9.99 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0 | 0.279 | 0.383 | Better than the National Benchmark | The best result, shared by 19% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 146 cases | 67 | 73 | 72.2 | Worse than 75% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 146 cases | 17 | 8 | 8.78 | Worse than 94% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 146 cases | 16 | 18 | 19.02 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 83 | 87 | 86.82 | Worse than 77% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 146 cases | 3 | 4 | 3.514 | Worse than 53% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 146 cases | 62 | 80 | 75.76 | Worse than 99% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 82 | 91 | 89.84 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 146 cases | 14 | 4 | 5.713 | Worse than 99% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 2.855 | The lowest rating, shared by 4% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 146 cases | 24 | 16 | 18.53 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 146 cases | 64 | 79 | 75.81 | Worse than 99% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 83 | 91 | 89.11 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 146 cases | 12 | 5 | 7.043 | Worse than 98% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 2.688 | The lowest rating, shared by 2% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 146 cases | 24 | 16 | 17.15 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 146 cases | 47 | 61 | 58.95 | Worse than 99% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 69 | 77 | 75.75 | Worse than 95% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 146 cases | 31 | 19 | 21.56 | Worse than 98% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 2.449 | The lowest rating, shared by 7% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 146 cases | 22 | 19 | 19.48 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 75 | 86 | 84.61 | Worse than 98% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 146 cases | 25 | 13 | 15.03 | Worse than 98% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 3.08 | The lowest rating, shared by 4% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 146 cases | 75 | 87 | 84.97 | Worse than 98% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 146 cases | 30 | 14 | 16.39 | Worse than 99% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 146 cases | 70 | 86 | 83.61 | Worse than 99% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 58 | 74 | 70.69 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 13 | 7 | 8.855 | Worse than 96% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 29 | 19 | 20.45 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 63 | 77 | 73.94 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 13 | 6 | 7.637 | Worse than 98% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 24 | 17 | 18.43 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 72 | 85 | 81.99 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 11 | 3 | 4.958 | Worse than 99% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 17 | 11 | 13.06 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 146 cases | 15 | 8 | 10.01 | Worse than 92% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 146 cases | 34 | 20 | 22.36 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 146 cases | 51 | 72 | 67.63 | Worse than 98% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 82 | 88 | 86.85 | Worse than 93% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 146 cases | 2 | 3 | 3.047 | Worse than 78% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 146 cases | 65 | 74 | 72.06 | Worse than 94% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 146 cases | 14 | 9 | 10.94 | Worse than 87% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 146 cases | 21 | 16 | 17 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 55 | 75 | 71.11 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 16 | 5 | 7.488 | Worse than 99% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 146 cases | 29 | 20 | 21.4 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 58 | 77 | 72.49 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 16 | 4 | 6.121 | Worse than 99% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 146 cases | 26 | 19 | 21.39 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 73 | 86 | 82.8 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 9 | 3 | 3.779 | Worse than 98% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 146 cases | 18 | 11 | 13.42 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 146 cases | 41 | 59 | 47.5 | Worse than 96% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 146 cases | 24 | 9 | 17.79 | Worse than 97% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 146 cases | 35 | 31 | 34.71 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 70 | 82 | 74.85 | Worse than 96% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 2.203 | The lowest rating, shared by 4% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 146 cases | 21 | 5 | 7.623 | Worse than 99% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 146 cases | 55 | 71 | 68.6 | Worse than 94% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 146 cases | 74 | 87 | 85.85 | Worse than 98% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 146 cases | 24 | 23 | 23.77 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 4 | 3.431 | The lowest rating, shared by 3% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 146 cases | 30 | 47 | 45.33 | Worse than 99% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 146 cases | 48 | 30 | 32.51 | Worse than 99% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 146 cases | 22 | 22 | 22.16 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 146 cases | 1 | 3 | 2.859 | The lowest rating, shared by 2% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 146 cases | 19 | 12 | 13.94 | Worse than 93% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 146 cases | 81 | 88 | 86.06 | Worse than 93% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 · 2,441 cases | 4 | 8 | 8.289 | Better than 74% of US hospitals | |
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 · 350 cases | 0 | 1 | 1.008 | The best result, shared by 34% of US hospitals | |
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.1852 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 667 cases | 37 | 79 | 69.96 | Worse than 94% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 412 cases | 138 | 154 | 187 | Better than 63% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 374 cases | 134 | 148 | 182 | Better than 61% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 · 29 cases | 226 | 247 | 282 | Better than 58% of US hospitals | |
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 411 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 8,413 cases | 2 | 1 | 2.162 | Worse than 58% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 75.06 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 | Not Available | 92.55 | |||
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 80 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 48.75 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 369 cases | 21 | 15 | 13.67 | Worse than 88% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 77 cases | 69 | 65 | 68.8 | Better than 58% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 20 cases | 85 | 73 | 76.38 | Better than 76% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 14 cases | 93 | 88 | 86.64 | Better than 65% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 77 cases | 75 | 82 | 82.89 | Worse than 73% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 39 cases | 97 | 94 | 93.98 | Better than 69% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 93.4 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 70.68 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 89.93 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 86.9 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 94.78 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 2.2 | 5 | 4.959 | Better than 83% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 8.417 |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 1.26 | 0.99 | 1.024 | Worse than 99% of US hospitals |
Measures CMS reports for the hospital's psychiatric unit or for a psychiatric hospital.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Follow-up care within 30 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 53.27 | |||
| Follow-up care within 7 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 33.73 | |||
| Hours of physical-restraint use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 3,858 cases | 0 | 0.05 | 0.9227 | The worst result, shared by 22% of US hospitals | |
| Hours of seclusion use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 3,858 cases | 0 | 0.03 | 0.8326 | The worst result, shared by 39% of US hospitals | |
| Psychiatric patients screened for and given the flu vaccine2024-10-01 to 2025-03-31 · 156 cases | 98 | 87 | 75.59 | Better than 82% of US hospitals | |
| Medication continuation after psychiatric discharge2022-07-01 to 2024-06-30 | Not Available | 77 | |||
| Readmitted to any hospital within 30 days of psychiatric discharge2022-07-01 to 2024-06-30 · 423 cases | 17.9 | 19.1 | 19.17 | No Different Than the National Rate | Better than 69% of US hospitals |
| Psychiatric patients screened for metabolic disorders2024-01-01 to 2024-12-31 · 178 cases | 95 | 92 | 83.77 | Better than 61% of US hospitals | |
| Alcohol use brief intervention provided or offered2024-01-01 to 2024-12-31 | Not Available | 65.57 | |||
| Alcohol use brief intervention provided2024-01-01 to 2024-12-31 | Not Available | 70.11 | |||
| Alcohol and other drug use disorder treatment provided or offered at discharge2024-01-01 to 2024-12-31 | Not Available | 64.72 | |||
| Alcohol and other drug use disorder treatment provided at discharge2024-01-01 to 2024-12-31 | Not Available | 54.45 | |||
| Tobacco use treatment provided or offered at discharge2024-01-01 to 2024-12-31 | Not Available | 50.58 | |||
| Tobacco use treatment provided at discharge2024-01-01 to 2024-12-31 | Not Available | 23.57 | |||
| Discharged patients who received a transition record with the specified elements2024-01-01 to 2024-12-31 · 240 cases | 6 | 77 | 55.11 | Worse than 84% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 55 | 20 | 30.07 | Better than 93% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 13.75 | 5 | 7.571 | Better than 93% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 0 | 10 | 16.48 | The worst result, shared by 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 0 | 2.5 | 4.567 | The worst result, shared by 43% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 25 | 34 | 28.67 | Worse than 68% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 6.25 | 8.75 | 7.519 | Worse than 68% of US hospitals | |
| VBP safety domain scoreFY 2026 | 80 | 40 | 45.16 | Better than 94% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 20 | 10 | 11.79 | Better than 93% of US hospitals | |
| VBP total performance scoreFY 2026 | 40 | 29.5 | 30.43 | Better than 80% of US hospitals |
| By fiscal year | FY 2021 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 66.67 | Not Available | 70 | 50 | 55 |
| VBP clinical outcomes weighted domain score | 16.67 | Not Available | 17.5 | 12.5 | 13.75 |
| VBP efficiency and cost reduction domain score | 0 | 0 | 0 | 0 | 0 |
| VBP efficiency and cost reduction weighted domain score | 0 | 0 | 0 | 0 | 0 |
| VBP person and community engagement domain score | 15 | Not Available | 0 | 1 | 25 |
| VBP person and community engagement weighted domain score | 3.75 | Not Available | 0 | 0.25 | 6.25 |
| VBP safety domain score | 50 | Not Available | 85 | 40 | 80 |
| VBP safety weighted domain score | 12.5 | Not Available | 21.25 | 10 | 20 |
| VBP total performance score | 32.92 | Not Available | 38.75 | 22.75 | 40 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.015 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 1.005 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 · 33 cases | 1.052 | 0.9969 | 1.002 | Worse than 87% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 81 cases | 1.023 | 0.9983 | 1.017 | Worse than 65% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9788 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 174 cases | 1.028 | 0.9955 | 1.026 | Worse than 69% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9865 | 1.002 | N/A | N/A | N/A | 1.052 |
| READM-30-HF-HRRP | 0.9901 | 0.9898 | 0.9412 | 0.9912 | 1.042 | 1.023 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.102 | 1.087 | 1.094 | 0.9822 | 1.006 | 1.028 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.925 | 0.489 | 0.6114 | Worse than 83% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.113 | 0.346 | 0.449 | Better than 84% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.559 | 0.679 | The best result, shared by 14% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.6405 | 0.7204 | The best result, shared by 12% of US hospitals | |
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9457 | 0.9628 | 0.9656 | Better than 57% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8116 | |||
| Total HAC scoreFY 2026 | -0.6552 | -0.0453 | 0.02733 | Better than 86% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | No | No | No |
| Total HAC score | -0.6364 | -0.1479 | 0 | -0.7881 | -0.7897 | -0.6552 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 2023)
Accreditation
None
Medical school affiliation
Private (for profit)
Ownership type
150
Medicare-certified beds
87
Registered nurses (full-time equivalent)
1976
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Encino Hospital Medical Center reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
1,536
Inpatient discharges
Medicare 56%, Medicaid 3%
6,497
Inpatient days
22% of available bed days used
252
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 839059). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Encino Hospital Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 3,651 | 186 | 2,660 | 6,497 |
| Discharges | 859 | 42 | 635 | 1,536 |
| Average length of stay | 4.3 days | 4.4 days | 4.2 days | 4.2 days |
| Average daily census | 10.0 | 0.5 | 7.3 | 17.8 |
857
Medicare Advantage days
183 discharges
1,244
Medicaid managed care days
259 discharges
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 60 | 5,636 | 3,299 | 26% |
| Coronary care unit | 22 | 861 | 352 | 11% |
| Subprovider - ipf | 13 | 4,042 | 3,378 | 85% |
| Subprovider - irf | 25 | 2,618 | 2,490 | 29% |
| Skilled nursing facility | 28 | 8,939 | 100 | 87% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Encino Hospital Medical Center treats Medicare patients for most often, in 2024. 353 Medicare discharges in 12 published DRGs; 4% surgical; 90% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 117 | $91,446 | $18,131 | $19,204 | 1.98 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 33 | $83,401 | $14,453 | $17,514 | 1.70 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 33 | $41,294 | $11,524 | $8,672 | 1.32 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 32 | $36,881 | $9,944 | $7,745 | 1.17 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 28 | $50,112 | $13,073 | $10,523 | 1.59 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 23 | $24,761 | $6,508 | $5,200 | 0.78 |
| Heart failure and shock with MCCMS-DRG 291, medical | 20 | $51,301 | $11,516 | $10,773 | 1.28 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 16 | $46,062 | $10,293 | $9,673 | 1.10 |
| Renal failure with MCCMS-DRG 682, medical | 15 | $44,811 | $13,552 | $9,410 | 1.50 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 14 | $372,277 | $58,902 | $78,178 | 5.00 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $38,821 | $13,633 | $8,152 | 1.51 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 11 | $55,789 | $11,424 | $11,716 | 1.23 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) Encino Hospital Medical Center billed Medicare for most in 2024: 13 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 13 | $23,858 | $2,239 | $1,752 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at Encino Hospital Medical Center in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 674 in 2020 to 646 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 91316 | 106 | 16% | 440 | $8.3M | 7% | 7% |
| 91436 | 99 | 15% | 451 | $8.1M | 13% | 18% |
| 91403 | 94 | 15% | 380 | $6.6M | 10% | 14% |
| 91406 | 49 | 8% | 244 | $4.4M | 3% | 2% |
| 91335 | 47 | 7% | 213 | $4.4M | 2% | 2% |
| 91356 | 43 | 7% | 168 | $3.1M | 3% | 3% |
| 91423 | 30 | 5% | 128 | $2.9M | 3% | 4% |
| 91364 | 28 | 4% | 91 | $1.5M | 2% | |
| 91411 | 23 | 4% | 153 | $3M | 4% | 5% |
| 91401 | 21 | 3% | 99 | $1.6M | 2% | 3% |
| 91405 | 21 | 3% | 84 | $1.4M | 1% | 2% |
| 91367 | 18 | 3% | 63 | $1.1M | 1% | 1% |
| 91606 | 16 | 2% | 53 | $1M | 1% | 2% |
| 91402 | 15 | 2% | 62 | $847,967 | 1% | 1% |
| 91607 | 14 | 2% | 63 | $1.1M | 1% | 1% |
| 91306 | 11 | 2% | 39 | $689,336 | 1% | |
| 91344 | 11 | 2% | 38 | $631,596 | 1% |
Source: CMS Hospital Service Area file. Shares are of the 646 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Encino Hospital Medical Center reported at its latest Medicare certification survey (2023). Counts are people, not full-time equivalents.
25
Psychiatric unit beds
25
Rehabilitation unit beds
87
Registered nurses
5
Pharmacists
6
Respiratory therapists
12
Physical therapists
4
Occupational therapists
2
Dietitians
1
Social workers
Source: CMS Provider of Services file.
88 clinicians who bill Medicare list Encino Hospital Medical Center as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Shahryar Yadegar, M.D.
Specialist
NPI 1174546493
See commercial rates for Shahryar Yadegar, M.D.Keino Rutherford, MD
Internal Medicine Physician
NPI 1497807853
See commercial rates for Keino Rutherford, MDBrittany Brinley, D.O.
Internal Medicine Physician
NPI 1649616855
See commercial rates for Brittany Brinley, D.O.Krikor Tatoyan, M.D.
Surgery Physician
NPI 1598936726
See commercial rates for Krikor Tatoyan, M.D.Sujie Tang, M.D.
Hematology & Oncology Physician
NPI 1134302409
See commercial rates for Sujie Tang, M.D.Danny Farah, MD
Nephrology Physician
NPI 1154416808
See commercial rates for Danny Farah, MDNima Rabbani, D.O., M.S.
Nephrology Physician
NPI 1619179454
See commercial rates for Nima Rabbani, D.O., M.S.Oleg Liakhovetski, M.D.
Internal Medicine Physician
NPI 1154584316
See commercial rates for Oleg Liakhovetski, M.D.Vahan Koshkaryan, MD
Interventional Cardiology Physician
NPI 1295026482
See commercial rates for Vahan Koshkaryan, MDEyal Shtorch, MD
Nephrology Physician
NPI 1942395603
See commercial rates for Eyal Shtorch, MDJerrold Dreyer, M.D.
Infectious Disease Physician
NPI 1316962756
See commercial rates for Jerrold Dreyer, M.D.Maryam Seddigh Tonekaboni, M.D.
Family Medicine Physician
NPI 1851663744
See commercial rates for Maryam Seddigh Tonekaboni, M.D.Hooman Kashani, DO
Nephrology Physician
NPI 1124117452
See commercial rates for Hooman Kashani, DOVartan Vartanians, M.D.
Diagnostic Radiology Physician
NPI 1154685758
See commercial rates for Vartan Vartanians, M.D.Aaron Shelub, M.D.
Specialist
NPI 1124103619
See commercial rates for Aaron Shelub, M.D.Susanna Ovsepyan
Psychiatric/Mental Health Nurse Practitioner
NPI 1154029874
See commercial rates for Susanna OvsepyanEugene Karpus, M.D.
Psychiatry Physician
NPI 1831239920
See commercial rates for Eugene Karpus, M.D.Ali Hadadz, MD
General Practice Physician
NPI 1316970866
See commercial rates for Ali Hadadz, MDLeonard Adelson, MD
Pulmonary Disease Physician
NPI 1235152455
See commercial rates for Leonard Adelson, MDGeorges Tanbe, M.D.
Interventional Cardiology Physician
NPI 1679733646
See commercial rates for Georges Tanbe, M.D.Edmond Derderian, M.D.
Internal Medicine Physician
NPI 1114258944
See commercial rates for Edmond Derderian, M.D.Monica Abigail Keh, NP
Acute Care Nurse Practitioner
NPI 1750930707
See commercial rates for Monica Abigail Keh, NPHassan Farrag, M.D.
Psychiatry Physician
NPI 1770684896
See commercial rates for Hassan Farrag, M.D.Sanjay Vadgama, M.D.
Pulmonary Disease Physician
NPI 1679548556
See commercial rates for Sanjay Vadgama, M.D.Source: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Encino Hospital Medical Center reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $292.7M | 523.0% |
| Inpatient | $242.2M | 432.8% |
| Outpatient | $50.5M | 90.2% |
| Contractual allowances and discounts | -$236.7M | -423.0% |
| Net patient revenue | $56M | 100.0% |
| Operating expenses | -$56.1M | -100.3% |
| Operating income from patient care | -$145,843 | -0.3% |
| Other income | $491,054 | 0.9% |
| Contributions and donations | $362,868 | 0.6% |
| Other | $128,186 | 0.2% |
| Net income | $345,211 | 0.6% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $53.1M | 18.1% |
| Medicaid (including managed care) | $84M | 28.7% |
| Other payers and self-pay | $155.6M | 53.2% |
| Total charges | $292.7M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Encino Hospital Medical Center's latest cost report.
-0.3%
Operating margin
Operating income from patient care / net patient revenue
0.6%
Total margin
Net income / net patient revenue plus other income
4.2%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
58% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$44.29
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
0.9%
Return on assets
Net income for a year / total assets
1.3%
Return on equity
Net income for a year / fund balance
1.39
Current ratio
Current assets / current liabilities
1.05
Quick ratio
Cash, temporary investments and net receivables / current liabilities
0 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
69 days
Days in patient receivables
Net patient receivables / daily net patient revenue
68 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.49
Asset turnover
Total revenue for a year / total assets
18.3 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Encino Hospital Medical Center owned and owed at the end of its reporting period (Dec 2025), across all fund types: $38M in total assets and a $26.3M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $45,713 | 0.1% |
| Patient receivables, net | $10.5M | 27.7% |
| Inventory | $685,967 | 1.8% |
| Total current assets | $14M | 36.9% |
| Property and equipment, net of depreciation | $24M | 63.1% |
| Total assets | $38M | 100.0% |
| Current liabilities | $10.1M | 26.6% |
| Total liabilities | $11.7M | 30.8% |
| Fund balance (net assets) | $26.3M | 69.2% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Encino Hospital Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$873,921
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$2.3M
Bad debt
Patient bills written off as uncollectible, at charges
-$2.9M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$1.4M
Total unreimbursed and uncompensated care
2.5% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Encino Hospital Medical Center's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Dec 2020 | Dec 2021 | Dec 2022 | Dec 2023 | Dec 2024 | Dec 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $51.3M | $53.2M | $56.8M | $52.6M | $56.1M | $56M |
| Operating expenses | $53.4M | $55.7M | $54.3M | $57M | $60M | $56.1M |
| Operating margin | -4.2% | -4.9% | 4.5% | -8.4% | -6.9% | -0.3% |
| Net income | $811,564 | -$1.6M | $3.2M | -$4.1M | -$2.4M | $345,211 |
| Total assets | $56.8M | $54.4M | $44.8M | $40.6M | $39.5M | $38M |
| Discharges | 1,286 | 1,330 | 1,508 | 1,490 | 1,382 | 1,536 |
| Inpatient days | 5,450 | 5,851 | 6,324 | 6,430 | 6,295 | 6,497 |
| Medicare Advantage days | 284 | 654 | 942 | 961 | 845 | 857 |
| Beds | 148 | 148 | 148 | 148 | 148 | 148 |
| Employees (FTE) | 211 | 201 | 198 | 335 | 248 | 252 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Encino Hospital Medical Center reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Emergency | $2.1M | $4.4M | $32.5M | 0.13 | 3,137 |
| Operating room | $1.2M | $3.4M | $3M | 1.14 | 13,096 |
| Respiratory therapy | $1.5M | $2.9M | $70M | 0.04 | 1,821 |
| Drugs charged to patients | $2.8M | $24.3M | 0.11 | ||
| Laboratory | $1.1M | $2.4M | $32.9M | 0.07 | 3,459 |
| Medical supplies charged to patient | $2.2M | $21M | 0.10 | ||
| Physical therapy | $1.2M | $4.2M | 0.29 | 4,801 | |
| Ct scan | $706,269 | $1.2M | $14.2M | 0.08 | 533 |
| Radiology-diagnostic | $324,572 | $1M | $4M | 0.25 | 2,836 |
| Ultrasound | $240,647 | $476,871 | $1.5M | 0.32 | 628 |
| Impl. dev. charged to patients | $360,085 | $2.2M | 0.17 | ||
| Anesthesiology | $259,582 | $634,200 | 0.41 | ||
| Radioisotope | $116,285 | $251,730 | $90,853 | 2.77 | 588 |
| Electrocardiology | $144,664 | $241,259 | $2.4M | 0.10 | 60 |
| Renal dialysis | $230,614 | $1.5M | 0.15 | 97 | |
| Blood storing processing & trans. | $164,691 | $534,931 | 0.31 | 180 | |
| Speech pathology | $133,929 | $1.5M | 0.09 | 112 | |
| Occupational therapy | $105,425 | $2.4M | 0.04 | 154 | |
| Electroencephalography | $2,973 | $13,524 | 0.22 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $4.1M | $10.3M | $29.1M | 0.35 | 22,381 |
| Skilled nursing facility | $3.7M | $8.7M | $17.7M | 0.49 | 11,975 |
| Subprovider - irf | $1.7M | $5.4M | $8.1M | 0.67 | 10,386 |
| Subprovider - ipf | $1.5M | $3.5M | $12.1M | 0.29 | 4,253 |
| Coronary care unit | $1.2M | $2.7M | $6.8M | 0.39 | 2,570 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.4M | $9.6M | 65,948 | $35.90 | 12,947 |
| Operation of plant | $1.3M | $4.1M | 43,096 | $29.74 | 11,337 |
| Cap rel costs-mvble equip | $1.5M | ||||
| Cap rel costs-bldg & fixt | $1.5M | 131,654 | |||
| Housekeeping | $989,048 | $1.4M | 40,971 | $24.14 | 320 |
| Pharmacy | $1.1M | $1.4M | 17,542 | $61.84 | 978 |
| Employee benefits department | $212,370 | $1.3M | 5,559 | $38.20 | 184 |
| Nursing administration | $1M | $1.2M | 14,168 | $72.04 | 150 |
| Dietary | $821,494 | $1M | 20,110 | $27.02 | 1,046 |
| Medical records & library | $106,945 | $767,633 | 5,021 | $21.30 | 743 |
| Maintenance & repairs | $504,194 | 12,000 | |||
| Cafeteria | $417,203 | 10,293 | $27.02 | 5,705 | |
| Laundry & linen service | $266,791 | 300 | |||
| Central services & supply | $124,611 | $100,639 | 5,168 | $24.11 | 2,363 |
| Social service | $61,458 | $76,506 | 1,976 | $31.10 | 316 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839059, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays Encino Hospital Medical Center for an inpatient stay.
1.60
Case mix index
Higher than 39% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
40.6%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
823
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.62 | 1.62 | 1.82 | 1.73 | 1.63 | 1.73 | 1.60 |
| Wage index | 1.290 | 1.284 | 1.297 | 1.519 | 1.451 | 1.431 | 1.399 |
| Readmissions adjustment | -0.16% | -0.72% | -0.62% | 0.00% | 0.00% | -0.08% | -0.22% |
| Value-based purchasing adjustment | +0.80% | +0.11% | +0.11% | -0.25% | +1.68% | +0.04% | +0.76% |
| Medicare inpatient stays | 855 | 855 | 585 | 706 | 761 | 764 | 823 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Encino Hospital Medical Center reports to Medicare as owners or with operational control.
Prime Healthcare Foundation Inc
5% or greater indirect ownership interest, 100%, since 2010
Sources: CMS Hospital All Owners.
The officers and board members on Encino Hospital Medical Center's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 3 of 5 are shown.
340B drug pricing program
Not participating
340B ID DSH050158, registered as a disproportionate share hospital. Authorizing official: Bockhi Park, Chief Executive Officer.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Encino hospital-psych
CCN 05S158, certified 1991, Medicare prospective payment
Encino hospital-rehab
CCN 05T158, certified 1998, Medicare prospective payment
Encino hospital-snf
CCN 555380, certified 1989, Medicare prospective payment
Source: Worksheet S-2 Part I of Encino Hospital Medical Center's latest Medicare cost report (HCRIS).
About Encino Hospital Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Encino Hospital Medical Center range from $379 to $447 across 2 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $447. The median at nearby comparable hospitals is $1,521. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Encino Hospital Medical Center range from $371 to $471 across 2 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $371. The median at nearby comparable hospitals is $1,552. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Encino Hospital Medical Center range from $998 to $1,914 across 2 insurers. Aetna's rate is $1,914. The median at nearby comparable hospitals is $4,434. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Encino Hospital Medical Center range from $180 to $180 across 1 insurers. Aetna's rate is $180. The median at nearby comparable hospitals is $530. What a patient pays depends on their plan's deductible, coinsurance and network status.
Encino Hospital Medical Center has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.
CMS reports no Medicare-funded interns or residents at Encino Hospital Medical Center for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Encino Hospital Medical Center's base inpatient payments by an estimated 0.22% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (117 discharges), respiratory infections and inflammations with mcc (33 discharges), miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc (33 discharges).
Encino Hospital Medical Center's Medicare case mix index is 1.60 for fiscal year 2027, higher than 39% of hospitals paid under the inpatient prospective payment system.
Encino Hospital Medical Center reported 1,536 inpatient discharges and 6,497 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Encino Hospital Medical Center reported 252 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Encino Hospital Medical Center reported $56M in net patient revenue on $292.7M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of -0.3%, and net income of $345,211.
Encino Hospital Medical Center reported $1.4M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $873,921 of charity care at cost.
Encino Hospital Medical Center's Medicare enrollment lists Em Garcia as Chief Executive Officer since 2013.
Insurers' price transparency files list Encino Hospital Medical Center under employer identification number 26-2128507 (Prime Healthcare Services-Encino). 33 health plans and networks list 26-2128507 for it.
HRSA's 340B database lists Encino Hospital Medical Center (340B ID DSH050158) as no longer participating since 2019.
88 clinicians who bill Medicare list Encino Hospital Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are acute care nurse practitioner (11), emergency medicine physician (9), internal medicine physician (8).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Encino Hospital Medical Center, effective 2023.
In its Medicare enrollment, Encino Hospital Medical Center reports Prime Healthcare Foundation Inc as 5% or greater indirect ownership interest (100%).
CMS lists 23 services at Encino Hospital Medical Center, including Acute Renal Dialysis, Adult Inpatient Psychiatric Care, Anesthesia, Clinical Laboratory, Coronary Care Unit, Diagnostic Radiology.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Encino Hospital Medical Center came from ZIP codes 91316 (106), 91436 (99), 91403 (94).
Encino Hospital Medical Center has 148 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 150 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Encino Hospital Medical Center is located at 16237 Ventura Boulevard, Encino, CA 91436. Its main phone number is (818) 995-5000.
Encino Hospital Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 050158.
The National Provider Identifier (NPI) on file for Encino Hospital Medical Center is 1437322377.
Encino Hospital Medical Center is affiliated with Prime Healthcare Services.
Encino Hospital Medical Center lists 19 in-network payers, including Aetna, Ameri Health, Avera Health Plans, Centene, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
47 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers