Montefiore Medical Center · Mount Vernon, NY
3 of 5
CMS star rating
85
Beds
2,927
Inpatient discharges a year
$76.8M
Net patient revenue a year
30
In-network payers
Montefiore Mount Vernon Hospital is an 85-bed voluntary non-profit - private hospital in Mount Vernon, NY, affiliated with Montefiore Medical Center. Below you'll find publicly disclosed negotiated rates and facility details, including 30 in-network payers and 257 disclosed rate categories.
The 24 services Montefiore Mount Vernon Hospital 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.
CT imaging
CPT 74177
$608 - $3,163
from 4 insurers · median $1,987
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$3,195 - $10,659
from 3 insurers · median $7,485
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$3,073 - $10,659
from 3 insurers · median $6,823
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,949 - $10,659
from 3 insurers · median $5,316
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 460
$93,825 - $101,938
from 2 insurers · median $97,881
Hospital reports orthopedic surgery services to CMS
CT imaging
CPT 70450
$226 - $1,573
from 4 insurers · median $740
Typical for a hospital with this service line
CT imaging
CPT 74176
$367 - $2,913
from 4 insurers · median $1,707
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 473
$64,070 - $76,645
from 3 insurers · median $72,702
Hospital reports orthopedic surgery services to CMS
Digestive procedures
CPT 45378
$3,316 - $10,659
from 4 insurers · median $5,902
Typical for a hospital with this service line
Mammography
CPT 77067
$217 - $642
from 4 insurers · median $389
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$48,266 - $59,307
from 3 insurers · median $59,059
Hospital reports orthopedic surgery services to CMS
Cardiology and vascular testing
CPT 93306
$375 - $2,076
from 4 insurers · median $1,060
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$4,436 - $11,365
from 3 insurers · median $7,485
Typical for a hospital with this service line
Gynecology
CPT 58571
$4,401 - $17,167
from 3 insurers · median $13,683
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 743
$29,916 - $76,801
from 4 insurers · median $36,614
Hospital reports inpatient surgical services to CMS
X-ray and bone density
CPT 71046
$71 - $312
from 4 insurers · median $223
Typical for a hospital with this service line
CT imaging
CPT 71260
$367 - $2,378
from 4 insurers · median $955
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,253 - $2,938
from 4 insurers · median $2,739
Hospital reports nuclear medicine services to CMS
Orthopedics and pain
CPT 20610
$680 - $5,316
from 4 insurers · median $3,341
Typical for a hospital with this service line
MRI imaging
CPT 70551
$470 - $4,482
from 4 insurers · median $1,663
Typical for a hospital with this service line
Ear, nose and throat
CPT 69436
$3,621 - $10,659
from 3 insurers · median $7,118
Typical for a hospital with this service line
MRI imaging
CPT 72148
$518 - $4,141
from 4 insurers · median $1,589
Typical for a hospital with this service line
Gynecology
CPT 58558
$3,316 - $11,365
from 3 insurers · median $7,302
Typical for a hospital with this service line
Ultrasound
CPT 76705
$202 - $844
from 4 insurers · median $435
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* | 16 | 695% | 14 | 2 |
| Insurer B* | 21 | 580% | 21 | 0 |
| Insurer C* | 24 | 231% | 18 | 1 |
| Insurer D* | 24 | 199% | 17 | 4 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 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 Montefiore Mount Vernon Hospital, 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
$76.8M net patient revenue
Ownership and leadership
Private (not for profit)
The employer identification numbers (EINs) health plans and networks list for Montefiore Mount Vernon Hospital 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 |
|---|---|---|
| 46-2916938Montefiore Mount Vernon Hospital | 40Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Aspirus Health Plan and 35 more | 1992131320 Montefiore Mount Vernon Hospital1013345065 Montefiore Mount Vernon Hospital1205990850 The Mount Vernon Hospitaland 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.
12 North Seventh Avenue, Mount Vernon, NY 10550
(914) 664-8000
How Montefiore Mount Vernon Hospital 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
No different on 3 measures
0 better, 3 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
2 of 5
Lower than 81% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
65%
Lower than 73% 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)
0.97
Higher than 54% 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
195 min
Higher than 78% 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
33%
Lower than 96% 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 | No different on 3 measures | |
| Safety | No different on 2 measures | |
| Readmissions | No different on 2 measures | |
| Patient survey ratingCMS: Summary star rating | 2 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 65% | 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) | 0.97 | 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 | 195 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 33% | 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 Montefiore Mount Vernon Hospital's inpatient payments for its readmissions, quality and cost results.
No penalty
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
-1.15% 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 Montefiore Mount Vernon Hospital, beside the US median and the average of NY 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 | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 3.952 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 636 cases | 4.2 | 3.9 | 3.707 | Worse than 63% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.31 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 1.91 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.316 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 26 cases | 9.8 | 11 | 10.43 | Better than 73% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 48 cases | 13.1 | 15.2 | 14.6 | Better than 80% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 27 cases | 11 | 11.6 | 11.03 | Better than 61% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 378 cases | 0.54 | 0.51 | 0.9123 | No Different Than the National Rate | Worse than 54% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 184 | |||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 484 cases | 0.21 | 0.2 | 0.2101 | No Different Than the National Rate | Worse than 54% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 486 cases | 0.27 | 0.27 | 0.2858 | No Different Than the National Rate | Worse than 46% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 25 cases | 2.32 | 2.29 | 2.43 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.674 | Number of Cases Too Small | ||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 9.324 | Number of Cases Too Small | ||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 26 cases | 3.49 | 3.4 | 3.686 | No Different Than the National Rate | Worse than 61% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.465 | Number of Cases Too Small | ||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.729 | Number of Cases Too Small | ||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 | Not Available | 1.053 | Number of Cases Too Small |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 10.66 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 | Not Available | 26.25 | |||
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 49 cases | 1.5 | 3.85 | 27.98 | Better than 53% 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 | 12.82 | Number of Cases Too Small | ||
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.22 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.026 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 0.9336 | Number of cases too small | ||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.47 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 10.69 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 58 cases | 19.6 | 19.8 | 20.27 | Better than 58% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 73 cases | 22.6 | 21.3 | 21.89 | Worse than 84% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.589 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 163 cases | 17.1 | 17.2 | 17.78 | 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 | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2612 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.692 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 413 | 1,370 | 8,161 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.246 | 0.9835 | 8.553 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 4.683 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5488 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1924 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.442 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 467 | 1,799 | 8,098 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.235 | 1.377 | 10.38 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 4.583 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.4307 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2752 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.411 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 12 | 61 | 149 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.277 | 1.591 | 3.939 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.941 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.7341 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.4218 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.517 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 90.43 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.7508 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.708 | |||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 1.049 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2613 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.903 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 11,663 | 14,451 | 80,977 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.375 | 0.567 | 5.587 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 3.796 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.6195 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1972 | Better than the National Benchmark | ||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.717 | 0.747 | 0.8371 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 11,663 | 13,646 | 73,951 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 4.178 | 5.683 | 38.28 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 0 | 2 | 12.57 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0 | 0.279 | 0.3563 | 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 | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 188 cases | 76 | 73 | 68.99 | Better than 60% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 188 cases | 6 | 8 | 10.19 | Better than 65% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 188 cases | 18 | 18 | 20.83 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 90 | 87 | 84.97 | Better than 74% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 188 cases | 4 | 4 | 3.044 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 188 cases | 76 | 80 | 76.99 | Worse than 72% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 89 | 91 | 89.97 | Worse than 79% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 188 cases | 9 | 4 | 5.71 | Worse than 95% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 188 cases | 2 | 3 | 2.889 | Worse than 79% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 188 cases | 15 | 16 | 17.3 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 188 cases | 72 | 79 | 76.68 | Worse than 91% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 87 | 91 | 89.46 | Worse than 90% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 188 cases | 9 | 5 | 6.31 | Worse than 90% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 188 cases | 2 | 3 | 2.674 | Worse than 71% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 188 cases | 19 | 16 | 17.01 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 188 cases | 51 | 61 | 58.86 | Worse than 94% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 69 | 77 | 74.78 | Worse than 95% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 188 cases | 29 | 19 | 21.9 | Worse than 95% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 188 cases | 1 | 3 | 2.274 | The lowest rating, shared by 7% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 188 cases | 20 | 19 | 19.23 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 77 | 86 | 83.85 | Worse than 96% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 188 cases | 22 | 13 | 15.46 | Worse than 95% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 188 cases | 1 | 3 | 2.896 | The lowest rating, shared by 4% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 188 cases | 78 | 87 | 84.54 | Worse than 95% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 188 cases | 24 | 14 | 16.81 | Worse than 94% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 188 cases | 76 | 86 | 83.19 | Worse than 94% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 65 | 74 | 71.59 | Worse than 94% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 10 | 7 | 8.014 | Worse than 84% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 25 | 19 | 20.4 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 70 | 77 | 74.66 | Worse than 90% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 8 | 6 | 6.893 | Worse than 77% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 22 | 17 | 18.44 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 81 | 85 | 82.9 | Worse than 80% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 8 | 3 | 4.479 | Worse than 96% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 11 | 11 | 12.62 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 188 cases | 8 | 8 | 10.63 | Worse than 48% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 188 cases | 28 | 20 | 23.59 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 188 cases | 64 | 72 | 65.78 | Worse than 79% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 86 | 88 | 85.79 | Worse than 69% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 188 cases | 3 | 3 | 2.815 | Worse than 45% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 188 cases | 69 | 74 | 72.21 | Worse than 81% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 188 cases | 19 | 9 | 11.03 | Worse than 98% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 188 cases | 12 | 16 | 16.76 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 72 | 75 | 72.71 | Worse than 67% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 11 | 5 | 7.086 | Worse than 95% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 188 cases | 17 | 20 | 20.21 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 71 | 77 | 73.59 | Worse than 81% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 8 | 4 | 6.164 | Worse than 88% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 188 cases | 21 | 19 | 20.24 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 83 | 86 | 83.55 | Worse than 72% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 7 | 3 | 4 | Worse than 96% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 188 cases | 10 | 11 | 12.45 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 188 cases | 61 | 59 | 49.08 | Better than 54% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 188 cases | 16 | 9 | 16.57 | Worse than 83% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 188 cases | 23 | 31 | 34.35 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 81 | 82 | 75.47 | Worse than 52% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 188 cases | 3 | 3 | 2.296 | Worse than 44% 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 · 188 cases | 8 | 5 | 7.297 | Worse than 76% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 188 cases | 65 | 71 | 66.23 | Worse than 73% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 188 cases | 84 | 87 | 84.56 | Worse than 74% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 188 cases | 27 | 23 | 26.48 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 188 cases | 3 | 4 | 3.096 | Worse than 58% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 188 cases | 34 | 47 | 44.58 | Worse than 98% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 188 cases | 39 | 30 | 33.46 | Worse than 89% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 188 cases | 27 | 22 | 21.96 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 188 cases | 2 | 3 | 2.8 | Worse than 81% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 188 cases | 20 | 12 | 14.29 | Worse than 95% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 188 cases | 80 | 88 | 85.71 | Worse than 95% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | NY 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 | Not Available | 7.9 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.158 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.2381 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 591 cases | 72 | 79 | 69.3 | Worse than 61% 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 · 409 cases | 204 | 154 | 206 | Worse than 79% 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 · 349 cases | 195 | 148 | 200 | Worse than 78% 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 · 40 cases | 352 | 247 | 326 | Worse than 80% 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 · 23 cases | 430 | 293 | 350 | Worse than 89% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 18,115 cases | 1 | 1 | 2.294 | Better than 42% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 67.28 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 113 cases | 67 | 97 | 92.28 | Worse than 95% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 100 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 46.05 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 394 cases | 14 | 15 | 13.94 | Better than 52% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 33 cases | 33 | 65 | 58.55 | Worse than 96% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 70.43 | |||
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 83.41 | |||
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 33 cases | 58 | 82 | 77.52 | Worse than 96% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 17 cases | 65 | 94 | 86.12 | Worse than 98% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 · 25 cases | 100 | 98 | 96.71 | The best result, shared by 14% of US hospitals | |
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 77.25 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 · 31 cases | 81 | 94 | 92.87 | Worse than 96% of US hospitals | |
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 85.23 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 94.43 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | Not Available | 5.231 | |||
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 23.75 |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 1.21 | 0.99 | 0.9974 | Worse than 98% of US hospitals |
Measures CMS reports for the hospital's psychiatric unit or for a psychiatric hospital.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Follow-up care within 30 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 64.14 | |||
| Follow-up care within 7 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 45.75 | |||
| Hours of physical-restraint use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 8,736 cases | 0 | 0.05 | 0.188 | 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 · 8,736 cases | 0 | 0.03 | 0.1882 | The worst result, shared by 39% of US hospitals | |
| Psychiatric patients screened for and given the flu vaccine2024-10-01 to 2025-03-31 · 308 cases | 83 | 87 | 77.76 | Worse than 56% of US hospitals | |
| Medication continuation after psychiatric discharge2022-07-01 to 2024-06-30 · 75 cases | 74.7 | 78.1 | 83.01 | Worse than 65% of US hospitals | |
| Readmitted to any hospital within 30 days of psychiatric discharge2022-07-01 to 2024-06-30 · 71 cases | 19.9 | 19.1 | 18.47 | No Different Than the National Rate | Worse than 62% of US hospitals |
| Psychiatric patients screened for metabolic disorders2024-01-01 to 2024-12-31 · 445 cases | 70 | 92 | 85.51 | Worse than 83% of US hospitals | |
| Alcohol use brief intervention provided or offered2024-01-01 to 2024-12-31 · 89 cases | 47 | 74 | 63.27 | Worse than 72% of US hospitals | |
| Alcohol use brief intervention provided2024-01-01 to 2024-12-31 · 44 cases | 93 | 81 | 73.44 | Better than 72% of US hospitals | |
| Alcohol and other drug use disorder treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 125 cases | 50 | 77 | 73.79 | Worse than 75% of US hospitals | |
| Alcohol and other drug use disorder treatment provided at discharge2024-01-01 to 2024-12-31 · 125 cases | 42 | 56 | 60.31 | Worse than 64% of US hospitals | |
| Tobacco use treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 165 cases | 33 | 64 | 51.16 | Worse than 71% of US hospitals | |
| Tobacco use treatment provided at discharge2024-01-01 to 2024-12-31 · 165 cases | 8 | 4 | 20.6 | Better than 57% of US hospitals | |
| Discharged patients who received a transition record with the specified elements2024-01-01 to 2024-12-31 · 611 cases | 97 | 77 | 70.93 | Better than 81% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | Not Available | 30.89 | |||
| VBP clinical outcomes weighted domain scoreFY 2026 | Not Available | 7.74 | |||
| VBP efficiency and cost reduction domain scoreFY 2026 | 0 | 10 | 20.53 | The worst result, shared by 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 0 | 2.5 | 5.155 | The worst result, shared by 43% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 12 | 34 | 27.68 | Worse than 93% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 4 | 8.75 | 6.965 | Worse than 87% of US hospitals | |
| VBP safety domain scoreFY 2026 | 25 | 40 | 38.92 | Worse than 78% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 8.333 | 10 | 9.798 | Worse than 61% of US hospitals | |
| VBP total performance scoreFY 2026 | 12.33 | 29.5 | 29.44 | Worse than 98% of US hospitals |
| By fiscal year | FY 2021 | FY 2024 | FY 2026 |
|---|---|---|---|
| VBP clinical outcomes domain score | 26.67 | 15 | Not Available |
| VBP clinical outcomes weighted domain score | 8.889 | 5 | Not Available |
| VBP efficiency and cost reduction domain score | 0 | 50 | 0 |
| VBP efficiency and cost reduction weighted domain score | 0 | 16.67 | 0 |
| VBP person and community engagement domain score | 13 | 8 | 12 |
| VBP person and community engagement weighted domain score | 4.333 | 2.667 | 4 |
| VBP safety domain score | Not Available | Not Available | 25 |
| VBP safety weighted domain score | Not Available | Not Available | 8.333 |
| VBP total performance score | 13.22 | 24.33 | 12.33 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.001 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9565 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | N/A | 1.014 | |||
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | N/A | 1.015 | |||
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9473 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 | 0.969 | 0.9955 | 1.019 | Better than 68% 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 | 1.058 | 1.011 | N/A | N/A | N/A | N/A |
| READM-30-HF-HRRP | 1.039 | 1.038 | 1.069 | 0.9998 | N/A | N/A |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.104 | 1.109 | 1.052 | 0.9998 | N/A | 0.969 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | This hospital | US median | NY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.5606 | |||
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.294 | 0.346 | 0.4123 | Better than 58% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.6757 | |||
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8339 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9709 | 0.9628 | 1.099 | Worse than 54% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.793 | |||
| Total HAC scoreFY 2026 | -0.2231 | -0.0453 | 0.1475 | Better than 63% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | Yes | No | N/A | No | No | No |
| Total HAC score | 1.097 | 0.1041 | 0 | -0.7495 | -0.3275 | -0.2231 |
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 2016)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
245
Medicare-certified beds
138
Registered nurses (full-time equivalent)
1966
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Montefiore Mount Vernon Hospital reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
2,927
Inpatient discharges
Medicare 13%, Medicaid 10%
10,637
Inpatient days
46% of available bed days used
461
Employees (full-time equivalent)
2
Interns and residents (full-time equivalent)
Source: CMS cost report (HCRIS) (report 838719). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Montefiore Mount Vernon Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,671 | 1,117 | 7,849 | 10,637 |
| Discharges | 395 | 298 | 2,234 | 2,927 |
| Average length of stay | 4.2 days | 3.7 days | 3.5 days | 3.6 days |
| Average daily census | 4.6 | 3.1 | 21.5 | 29.1 |
3,352
Medicare Advantage days
910 discharges
2,006
Medicaid managed care days
571 discharges
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 63 | 10,637 | 1,671 | 46% |
| Subprovider - ipf | 22 | 8,493 | 685 | 106% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Montefiore Mount Vernon Hospital treats Medicare patients for most often, in 2024. 107 Medicare discharges in 8 published DRGs; 0% surgical; 64% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 19 | $49,972 | $11,826 | $17,540 | 1.28 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 15 | $35,144 | $7,877 | $12,335 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 14 | $44,529 | $11,772 | $15,630 | 1.17 |
| Cellulitis without MCCMS-DRG 603, medical | 13 | $40,937 | $7,554 | $14,369 | 0.88 |
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 13 | $68,229 | $16,804 | $23,948 | 1.98 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 11 | $55,461 | $12,917 | $19,467 | 1.33 |
| Renal failure with CCMS-DRG 683, medical | 11 | $48,862 | $9,159 | $17,151 | 0.90 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 11 | $34,807 | $13,495 | $12,217 | 1.76 |
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.
ZIP codes with the most Medicare inpatient stays at Montefiore Mount Vernon Hospital 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 640 in 2020 to 1,123 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 10550 | 397 | 35% | 1,527 | $20.2M | 22% | 24% |
| 10466 | 112 | 10% | 416 | $5.3M | 3% | |
| 10552 | 72 | 6% | 312 | $4.2M | 6% | 9% |
| 10475 | 66 | 6% | 260 | $2.6M | 2% | 0% |
| 10553 | 66 | 6% | 237 | $3.3M | 14% | 22% |
| 10467 | 52 | 5% | 193 | $2M | 1% | |
| 10473 | 49 | 4% | 190 | $1.9M | 1% | |
| 10462 | 47 | 4% | 194 | $1.9M | 1% | |
| 10469 | 44 | 4% | 164 | $1.7M | 1% | |
| 10472 | 38 | 3% | 147 | $1.4M | 1% | |
| 10461 | 34 | 3% | 154 | $1.5M | 1% | |
| 10460 | 31 | 3% | 105 | $1M | 1% | |
| 10465 | 24 | 2% | 100 | $1M | 1% | |
| 10470 | 21 | 2% | 78 | $1M | 3% | 2% |
| 10801 | 19 | 2% | 84 | $1M | 1% | 2% |
| 10458 | 17 | 2% | 36 | $377,566 | 0% | |
| 10703 | 12 | 1% | 56 | $562,083 | 1% | 1% |
| 10454 | 11 | 1% | 39 | $416,446 | 1% | |
| 10459 | 11 | 1% | 32 | $315,287 | 0% |
Source: CMS Hospital Service Area file. Shares are of the 1,123 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 Montefiore Mount Vernon Hospital reported at its latest Medicare certification survey (2025). Counts are people, not full-time equivalents.
8
Operating rooms
22
Psychiatric unit beds
1
Off-site locations
138
Registered nurses
6
Licensed practical nurses
18
Physicians
2
Resident physicians
2
Nurse practitioners
1
Physician assistants
7
Pharmacists
4
Respiratory therapists
6
Physical therapists
2
Speech pathologists and audiologists
2
Radiology technicians
1
Nuclear medicine technicians
12
Medical technologists
5
Dietitians
9
Social workers
1
Psychologists
322
Other personnel
Source: CMS Provider of Services file.
150 clinicians who bill Medicare list Montefiore Mount Vernon Hospital 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.
Marc Janis, MD
Urology Physician
NPI 1669587879
See commercial rates for Marc Janis, MDMahmood Kazmi
Psychiatry Physician
NPI 1669438875
See commercial rates for Mahmood KazmiPrakhar Agarwal, M.D.
Vascular & Interventional Radiology Physician
NPI 1326487653
See commercial rates for Prakhar Agarwal, M.D.Aaron Roth, MD
Surgery Physician
NPI 1710985379
See commercial rates for Aaron Roth, MDJudah Burns, MD
Diagnostic Radiology Physician
NPI 1699942318
See commercial rates for Judah Burns, MDSara Kingston, MD
Diagnostic Radiology Physician
NPI 1972999464
See commercial rates for Sara Kingston, MDSandeep Gulati, D.O.
Neurology Physician
NPI 1740292051
See commercial rates for Sandeep Gulati, D.O.Seymour Sprayregen, MD
Diagnostic Radiology Physician
NPI 1184717324
See commercial rates for Seymour Sprayregen, MDChristopher Adubor, MD
Nephrology Physician
NPI 1962464594
See commercial rates for Christopher Adubor, MDJonathan Sterman, MD
Student in an Organized Health Care Education/Training Program
NPI 1508248204
See commercial rates for Jonathan Sterman, MDArlette Shvartzman, MD
Diagnostic Radiology Physician
NPI 1922071851
See commercial rates for Arlette Shvartzman, MDMitchell Weiser, MD
Orthopaedic Surgery Physician
NPI 1619266863
See commercial rates for Mitchell Weiser, MDDaniel Treister, M.D.
Neuroradiology Physician
NPI 1720462385
See commercial rates for Daniel Treister, M.D.Yung Lee, MD
Diagnostic Radiology Physician
NPI 1528151784
See commercial rates for Yung Lee, MDEli Kamara, MD
Orthopaedic Surgery Physician
NPI 1750647517
See commercial rates for Eli Kamara, MDBindu Kaul, MD
Diagnostic Radiology Physician
NPI 1801989033
See commercial rates for Bindu Kaul, MDCarolyn Malone, MD
Diagnostic Radiology Physician
NPI 1295900843
See commercial rates for Carolyn Malone, MDCorey Hunter, M.D.
Interventional Pain Medicine Physician
NPI 1194999532
See commercial rates for Corey Hunter, M.D.Benjamin Berenfeld, M.D.
Orthopaedic Hand Surgery Physician
NPI 1548431687
See commercial rates for Benjamin Berenfeld, M.D.Gabriel Nemzow, M.D.
Internal Medicine Physician
NPI 1629529045
See commercial rates for Gabriel Nemzow, M.D.Steven Benitez
Diagnostic Radiology Physician
NPI 1417360165
See commercial rates for Steven BenitezMeir Scheinfeld, MD PHD
Diagnostic Radiology Physician
NPI 1053644294
See commercial rates for Meir Scheinfeld, MD PHDJonathan Trambert, MD
Diagnostic Radiology Physician
NPI 1023101268
See commercial rates for Jonathan Trambert, MDKameswari Lakshmi, MD
Nephrology Physician
NPI 1942324132
See commercial rates for Kameswari Lakshmi, MDSource: 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 Montefiore Mount Vernon Hospital reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $310.4M | 404.3% |
| Inpatient | $189M | 246.2% |
| Outpatient | $121.4M | 158.1% |
| Contractual allowances and discounts | -$233.6M | -304.3% |
| Net patient revenue | $76.8M | 100.0% |
| Operating expenses | -$113.9M | -148.4% |
| Operating income from patient care | -$37.1M | -48.4% |
| Other income | $27.9M | 36.4% |
| Contributions and donations | $27,750 | 0.0% |
| Government appropriations | $460,825 | 0.6% |
| Other | $27.5M | 35.8% |
| Net income | -$9.2M | -12.0% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $12.9M | 4.2% |
| Medicaid (including managed care) | $110.2M | 35.5% |
| Other payers and self-pay | $187.2M | 60.3% |
| Total charges | $310.4M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, 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 Montefiore Mount Vernon Hospital's latest cost report.
-48.4%
Operating margin
Operating income from patient care / net patient revenue
-8.8%
Total margin
Net income / net patient revenue plus other income
-6.0%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
64% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$59.52
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-16.9%
Return on assets
Net income for a year / total assets
0.43
Current ratio
Current assets / current liabilities
0.26
Quick ratio
Cash, temporary investments and net receivables / current liabilities
7 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
44 days
Days in patient receivables
Net patient receivables / daily net patient revenue
145 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.93
Asset turnover
Total revenue for a year / total assets
6.2 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Montefiore Mount Vernon Hospital owned and owed at the end of its reporting period (Dec 2025), across all fund types: $54.4M in total assets and a -$67.2M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $2M | 3.6% |
| Patient receivables, net | $9.2M | 17.0% |
| Total current assets | $18.8M | 34.6% |
| Property and equipment, net of depreciation | $22.6M | 41.6% |
| Investments and other assets | $13M | 23.8% |
| Total assets | $54.4M | 100.0% |
| Current liabilities | $43.9M | 80.8% |
| Total liabilities | $121.6M | 223.5% |
| Fund balance (net assets) | -$67.2M | -123.5% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Montefiore Mount Vernon Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$4.2M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$105,171
Bad debt
Patient bills written off as uncollectible, at charges
-$565,890
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$88,025
CHIP shortfall
Cost of stand-alone CHIP patients minus CHIP payments
$4.4M
Total unreimbursed and uncompensated care
3.8% 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 838719, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Montefiore Mount Vernon Hospital'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 | $44.8M | $44.6M | $56.2M | $58.1M | $266.8M | $76.8M |
| Operating expenses | $87.3M | $81.8M | $87.6M | $93.5M | $115.4M | $113.9M |
| Operating margin | -94.9% | -83.6% | -56.0% | -60.9% | 56.7% | -48.4% |
| Net income | $11M | -$3.2M | -$13.8M | -$31.8M | $180.7M | -$9.2M |
| Total assets | $61.4M | $47.7M | $41.5M | $41.9M | $51M | $54.4M |
| Discharges | 1,522 | 1,374 | 1,412 | 1,544 | 2,887 | 2,927 |
| Inpatient days | 7,127 | 5,043 | 5,275 | 5,752 | 11,141 | 10,637 |
| Medicare Advantage days | 1,700 | 1,054 | 1,298 | 1,489 | 3,608 | 3,352 |
| Beds | 85 | 85 | 85 | 85 | 85 | 85 |
| Employees (FTE) | 462 | 374 | 364 | 368 | 432 | 461 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Montefiore Mount Vernon Hospital 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 | $5M | $15M | $31.3M | 0.48 | 12,939 |
| Operating room | $2.5M | $9.3M | $23.7M | 0.39 | 17,223 |
| Laboratory | $2.3M | $7M | $24.5M | 0.29 | 4,504 |
| Clinic | $1.3M | $5.2M | $8M | 0.65 | 18,026 |
| Drugs charged to patients | $4.5M | $13M | 0.35 | ||
| Radiology-diagnostic | $1.3M | $4.2M | $4M | 1.05 | 11,062 |
| Mental health clinic | $1.4M | $3.3M | $3.5M | 0.97 | 13,440 |
| Respiratory therapy | $938,547 | $1.9M | $7.8M | 0.25 | 727 |
| Physical therapy | $587,490 | $1.4M | $6.1M | 0.24 | 4,849 |
| Ct scan | $685,373 | $1.4M | $19.7M | 0.07 | 720 |
| Anesthesiology | $3,816 | $1M | $8.8M | 0.12 | |
| Ultrasound diagnostic | $438,528 | $659,499 | $5.4M | 0.12 | 480 |
| Electrocardiology | $197,685 | $614,256 | $5.4M | 0.11 | 1,568 |
| Mri | $310,051 | $604,592 | $2.6M | 0.24 | 720 |
| Impl. dev. charged to patients | $528,325 | $3.2M | 0.17 | ||
| Blood storing processing & trans. | $385,266 | $430,806 | 0.89 | 191 | |
| Radioisotope | $109,527 | $306,233 | $465,463 | 0.66 | 665 |
| Medical supplies charged to patient | $208,828 | $2.9M | 0.07 | ||
| Sleep lab | $57,774 | $153,387 | $86,292 | 1.78 | 836 |
| Recovery room | $2,111 | $149,997 | $3.7M | 0.04 | 2,085 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $9.1M | $27.5M | $76M | 0.36 | 46,472 |
| Subprovider - ipf | $7.3M | $12.4M | $57.2M | 0.22 | 11,242 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Employee benefits department | $64,592 | $16.5M | 1,950 | $33.12 | 1,505 |
| Administrative & general | $6.4M | $12.6M | 105,244 | $43.01 | 40,816 |
| Operation of plant | $2M | $8.6M | 40,433 | $47.94 | 57,564 |
| Pharmacy | $1.5M | $3.3M | 1,983 | ||
| Central service & supply | $3.1M | 12,288 | |||
| Housekeeping | $1.5M | $2.5M | 53,482 | $27.38 | 2,196 |
| Cap rel costs-mvble equip | $2.1M | ||||
| Supervising physicians - teaching | $1.5M | $1.9M | 1,158 | ||
| Nursing administration | $1.5M | $1.6M | 1,216 | ||
| Cap rel costs-bldg & fixt | $1.4M | 365,532 | |||
| Dietary - other | $1.2M | $1.3M | 8,039 | ||
| Dietary - raw food | $839,111 | ||||
| Supervising physicians - other | $543,157 | 5,142 | |||
| Medical records & library | $308,548 | $488,208 | 5,545 | $28.63 | 7,394 |
| I&r services-salary & fringes apprv | $258,274 | $76,386 | 578 | ||
| Laundry & linen service | $8,534 | 1,030 | |||
| Cafeteria | $423,219 | -$80,825 | 12,982 | $32.60 | 4,700 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838719, 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 Montefiore Mount Vernon Hospital for an inpatient stay.
1.30
Case mix index
Higher than 11% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
Teaching hospital
Teaching status
0.07 residents per bed
Medicare-funded interns and residents per bed (FY 2027).
52.0%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
391
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 | 1.36 | 1.36 | 1.25 | 1.25 | 1.39 | 1.20 | 1.30 |
| Wage index | 1.347 | 1.343 | 1.333 | 1.356 | 1.306 | 1.370 | 1.427 |
| Readmissions adjustment | -0.19% | -0.43% | -0.45% | -0.13% | 0.00% | 0.00% | 0.00% |
| Value-based purchasing adjustment | +0.06% | -1.15% | -1.15% | 0.00% | +0.31% | 0.00% | -1.15% |
| Medicare inpatient stays | 700 | 700 | 198 | 176 | 197 | 335 | 391 |
Source: CMS IPPS final rule Impact File (FY 2027).
The officers and board members on Montefiore Mount Vernon Hospital'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 37 of 43 are shown.
| Name | Title |
|---|---|
| Philip O Ozuah MD PhD | President & CEO |
| Colleen Blye | Exec VP & CFO |
| Susan Green-Lorenzen RN | System Senior Vp-operations |
| Christopher S Panczner | Assistant Secretary |
| Regginald L Jordan | VP & Exec Director Mmv |
| Catherine Klema | Vice Chair |
| Emanuel Chirico | Treasurer |
| James M Butler | Chairman |
Board members: Alan N Suna, Alisa R Doctoroff, Allen M Spiegel MD, Barry S Blattman, Bruce Doniger, Daniel R Tishman, David B Keidan, Douglas F Eisenberg, Edwin H Stern III, Ellen Breslow Newhouse, Gayle F Robinson, Helen A Johnson, Jay B Abramson, Jennie Emil, Joel Braun, John Heffer, John P Gutfreund, Jon W Rotenstreich, Jonathan A Lipton, Lewis Henkind, Margaret L Nathan, Matthew H Nord, Melissa Ceriale, Nathan Gantcher, Patricia Bauman, Patricia Green, Ronald L Moelis, and 3 more on the return.
Source: IRS Form 990 Part VII filed by Montefiore Mount Vernon Hospital (EIN 46-2916938), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2024
340B ID DSH330086, registered as a disproportionate share hospital; 1 registered outpatient sites; 2 active contract pharmacies. Authorizing official: Regginald Jordan, Vice President, Executive Director.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
The mount vernon hospital psych
CCN 33S086, certified 1987, Medicare prospective payment
Source: Worksheet S-2 Part I of Montefiore Mount Vernon Hospital's latest Medicare cost report (HCRIS).
About Montefiore Mount Vernon Hospital's rates and hospital price transparency.
For MRI of the brain, without contrast (CPT 70551), published negotiated rates at Montefiore Mount Vernon Hospital range from $470 to $4,482 across 4 insurers. Cigna's rate is $4,482. The median at nearby comparable hospitals is $491. 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 Montefiore Mount Vernon Hospital range from $608 to $3,163 across 4 insurers. UnitedHealthcare's rate is $828. The median at nearby comparable hospitals is $711. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Montefiore Mount Vernon Hospital range from $3,195 to $10,659 across 3 insurers. Blue Cross Blue Shield's rate is $7,485. The median at nearby comparable hospitals is $3,177. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Montefiore Mount Vernon Hospital range from $217 to $642 across 4 insurers. Blue Cross Blue Shield's rate is $542. The median at nearby comparable hospitals is $234. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Montefiore Mount Vernon Hospital range from $48,266 to $59,307 across 3 insurers. Aetna's rate is $48,266. The median at nearby comparable hospitals is $35,960. What a patient pays depends on their plan's deductible, coinsurance and network status.
Montefiore Mount Vernon Hospital 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.
Yes. CMS counts 0.07 Medicare-funded residents per bed at Montefiore Mount Vernon Hospital for fiscal year 2027, so it is a teaching hospital.
No. Montefiore Mount Vernon Hospital has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.
In 2024, the most common were heart failure and shock with mcc (19 discharges), kidney and urinary tract infections without mcc (15 discharges), kidney and urinary tract infections with mcc (14 discharges).
Montefiore Mount Vernon Hospital's Medicare case mix index is 1.30 for fiscal year 2027, higher than 11% of hospitals paid under the inpatient prospective payment system.
Montefiore Mount Vernon Hospital reported 2,927 inpatient discharges and 10,637 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Montefiore Mount Vernon Hospital reported 461 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Montefiore Mount Vernon Hospital reported $76.8M in net patient revenue on $310.4M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of -48.4%, and net income of -$9.2M.
Montefiore Mount Vernon Hospital reported $4.4M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $4.2M of charity care at cost.
Montefiore Mount Vernon Hospital's Medicare enrollment lists Phillip O. Ozuah as President since 2013.
Insurers' price transparency files list Montefiore Mount Vernon Hospital under employer identification number 46-2916938 (Montefiore Mount Vernon Hospital). 40 health plans and networks list 46-2916938 for it.
Yes. HRSA's 340B database lists Montefiore Mount Vernon Hospital (340B ID DSH330086) as a participating disproportionate share hospital since 2024, with 2 active contract pharmacies.
150 clinicians who bill Medicare list Montefiore Mount Vernon Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are diagnostic radiology physician (31), emergency medicine physician (19), internal medicine physician (18).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Montefiore Mount Vernon Hospital, effective 2016.
CMS lists 28 services at Montefiore Mount Vernon Hospital, including Acute Renal Dialysis, Adult Inpatient Psychiatric Care, Alcohol and/or Drug Service, Anesthesia, Chemotherapy, Clinical Laboratory.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Montefiore Mount Vernon Hospital came from ZIP codes 10550 (397), 10466 (112), 10552 (72).
Montefiore Mount Vernon Hospital has 85 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 245 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Montefiore Mount Vernon Hospital is located at 12 North Seventh Avenue, Mount Vernon, NY 10550. Its main phone number is (914) 664-8000.
Montefiore Mount Vernon Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 330086.
The National Provider Identifier (NPI) on file for Montefiore Mount Vernon Hospital is 1992131320.
Montefiore Mount Vernon Hospital is affiliated with Montefiore Medical Center.
Montefiore Mount Vernon Hospital lists 30 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
257 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