SSM Health · Gainesville, TX
4 of 5
CMS star rating
35
Beds
1,633
Inpatient discharges a year
$47.2M
Net patient revenue a year
32
In-network payers
North Texas Medical Center is a 35-bed government - hospital district or authority hospital in Gainesville, TX, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 32 in-network payers and 335 disclosed rate categories.
The 24 services North Texas 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.
Childbirth · Inpatient
MS-DRG 807
$3,528 - $4,290
from 2 insurers · median $3,909
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$4,741 - $5,848
from 2 insurers · median $5,295
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$1,010 - $2,323
from 4 insurers · median $1,306
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$2,372 - $3,021
from 4 insurers · median $2,640
244 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
CT imaging
CPT 70450
$281 - $876
from 4 insurers · median $544
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$532 - $3,072
from 4 insurers · median $1,703
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$639 - $2,093
from 4 insurers · median $1,160
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$3,216 - $7,734
from 4 insurers · median $5,047
16 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Cardiology and vascular testing
CPT 93306
$226 - $1,772
from 4 insurers · median $982
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$760 - $1,625
from 4 insurers · median $1,398
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 49505
$3,360 - $4,975
from 2 insurers · median $4,167
13 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
Digestive procedures
CPT 49650
$5,055 - $7,734
from 2 insurers · median $6,394
16 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 45385
$760 - $1,634
from 4 insurers · median $1,572
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$1,004 - $2,281
from 4 insurers · median $1,531
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$138 - $319
from 4 insurers · median $189
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$792 - $2,673
from 4 insurers · median $1,351
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$3,528 - $4,290
from 2 insurers · median $3,909
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Gynecology
CPT 58571
$5,055 - $11,862
from 2 insurers · median $8,459
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$85 - $201
from 4 insurers · median $147
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$400 - $1,652
from 4 insurers · median $857
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 743
$7,902 - $16,854
from 4 insurers · median $14,647
Hospital reports inpatient surgical services to CMS
MRI imaging
CPT 70551
$387 - $1,581
from 4 insurers · median $808
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 29826
$301 - $9,693
from 4 insurers · median $7,035
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 77080
$41 - $858
from 4 insurers · median $418
Common here, based on CMS Medicare volume
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* | 18 | 345% | 6 | 10 |
| Insurer B* | 18 | 229% | 3 | 9 |
| Insurer C* | 24 | 166% | 6 | 11 |
| Insurer D* | 24 | 136% | 0 | 20 |
How we chose these services: 4 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 5 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 North Texas 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
4 of 5 stars
Doctors and services
Accredited by CIHQ
Finances
$47.2M net patient revenue
Ownership and leadership
Owned by Community Hospital Consulting, Inc
The employer identification numbers (EINs) health plans and networks list for North Texas 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 |
|---|---|---|
| 83-1683025North Texas Medical Center | 55Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 50 more | 1972071991 Gainesville Community Hospital Inc.1033687900 Gainesville Community Hospital Inc.1942778816 Gainesville Community Hospital Inc.and 6 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.
1900 Hospital Boulevard, Gainesville, TX 76240
(940) 612-8600
How North Texas Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
4 of 5
Higher than 58% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 5 measures
0 better, 5 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 3 measures
0 better, 3 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Better on 1 of 7 measures
1 better, 6 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
4 of 5
Higher than 60% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
73%
Higher than 54% 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)
1.22
Higher than 91% 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
117 min
Lower than 76% 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
78%
Higher than 80% 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 | 4 of 5 | |
| Death rates | No different on 5 measures | |
| Safety | No different on 3 measures | |
| Readmissions | Better on 1 of 7 measures | |
| Patient survey ratingCMS: Summary star rating | 4 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 73% | 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) | 1.22 | 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 | 117 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 78% | 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 North Texas Medical Center'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.
+0.36% 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 North Texas Medical Center, beside the US median and the average of TX 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 | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 · 33 cases | 4.6 | 4.1 | 4.144 | Worse than 72% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 479 cases | 3.9 | 3.9 | 3.887 | Better than 49% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.91 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.71 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 55 cases | 8.6 | 8.5 | 8.703 | Worse than 53% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 46 cases | 11.4 | 11 | 10.52 | Worse than 57% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 163 cases | 12.2 | 15.2 | 14.69 | Better than 89% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 12.01 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 862 cases | 1.06 | 0.51 | 0.52 | No Different Than the National Rate | Worse than 89% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 166 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 952 cases | 0.27 | 0.2 | 0.2079 | No Different Than the National Rate | Worse than 88% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 941 cases | 0.26 | 0.27 | 0.2646 | No Different Than the National Rate | Better than 54% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 84 cases | 2.31 | 2.29 | 2.31 | No Different Than the National Rate | Worse than 55% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 35 cases | 1.67 | 1.63 | 1.619 | No Different Than the National Rate | Worse than 72% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 34 cases | 12.05 | 8.88 | 10.06 | No Different Than the National Rate | Worse than 85% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 85 cases | 3.9 | 3.4 | 3.337 | No Different Than the National Rate | Worse than 78% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 31 cases | 5.22 | 5.105 | 5.234 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.771 | Number of Cases Too Small | ||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 46 cases | 1.05 | 1.02 | 1.035 | No Different Than the National Rate | Worse than 64% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.3 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 51 cases | -74 | 1.25 | -1.323 | Better than 99% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 182 cases | 2.6 | 3.85 | 2.422 | Better than 51% 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 · 473 cases | 12.4 | 12.9 | 13.1 | No Different Than the National Rate | Better than 79% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 10.89 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.287 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 52 cases | 0.9 | 1 | 1.017 | No Different than expected | Better than 68% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.48 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.35 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 77 cases | 19.6 | 19.8 | 19.85 | Better than 58% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 61 cases | 20.2 | 21.3 | 21.26 | Better than 83% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 · 33 cases | 5.5 | 5.8 | 5.89 | Better than 65% of US hospitals | |
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 227 cases | 16 | 17.2 | 17.32 | Better than 92% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2089 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.706 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 1,214 | 1,370 | 5,045 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.746 | 0.9835 | 5.124 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.481 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.524 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1526 | No Different than National Benchmark | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.299 | 1.392 | 1.474 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 2,596 | 1,799 | 4,197 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 1.303 | 1.377 | 5.155 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 1.82 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | 0 | 0.399 | 0.3671 | No Different than National Benchmark | The best result, shared by 24% of US hospitals |
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2931 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.124 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 2 | 61 | 131 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.062 | 1.591 | 3.62 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.647 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.6967 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3341 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.281 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 4 | 38 | 121 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.037 | 0.328 | 1.047 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.9659 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.973 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2282 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.053 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 6,598 | 14,451 | 42,649 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.165 | 0.567 | 2.717 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 1.635 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.6545 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.311 | 0.127 | 0.1195 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 1.879 | 0.747 | 0.935 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 6,253 | 13,646 | 38,870 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 5.897 | 5.683 | 20.56 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 5 | 2 | 4.894 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.848 | 0.279 | 0.2623 | No Different than National Benchmark | Worse than 92% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 300 cases | 76 | 73 | 75.97 | Better than 60% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 300 cases | 7 | 8 | 7.771 | Better than 56% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 300 cases | 17 | 18 | 16.26 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 89 | 87 | 87.82 | Better than 66% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 4 | 3.712 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 300 cases | 85 | 80 | 79.96 | Better than 79% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 94 | 91 | 90.97 | Better than 82% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 300 cases | 2 | 4 | 4.535 | Better than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 300 cases | 5 | 3 | 3.275 | The top rating, shared by 18% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 300 cases | 13 | 16 | 15.51 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 300 cases | 76 | 79 | 79.72 | Worse than 71% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 89 | 91 | 90.24 | Worse than 71% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 300 cases | 8 | 5 | 5.687 | Worse than 84% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 300 cases | 2 | 3 | 2.956 | Worse than 71% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 300 cases | 16 | 16 | 14.59 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 300 cases | 64 | 61 | 62.66 | Better than 64% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 81 | 77 | 76.88 | Better than 79% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 300 cases | 16 | 19 | 19.26 | Better than 69% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 3 | 2.672 | Better than 79% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 300 cases | 20 | 19 | 18.08 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 86 | 86 | 84.56 | Worse than 45% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 300 cases | 14 | 13 | 13.98 | Worse than 53% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 300 cases | 3 | 3 | 3.07 | Worse than 45% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 300 cases | 86 | 87 | 86.02 | Worse than 53% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 300 cases | 12 | 14 | 16.2 | Better than 68% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 300 cases | 88 | 86 | 83.8 | Better than 68% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 71 | 74 | 74.6 | Worse than 68% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 8 | 7 | 7.327 | Worse than 63% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 21 | 19 | 18.08 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 75 | 77 | 77.72 | Worse than 64% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 8 | 6 | 6.395 | Worse than 77% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 17 | 17 | 15.88 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 82 | 85 | 85.15 | Worse than 74% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 7 | 3 | 4.015 | Worse than 92% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 11 | 11 | 10.84 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 300 cases | 6 | 8 | 8.293 | Better than 63% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 300 cases | 23 | 20 | 18.19 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 300 cases | 71 | 72 | 73.52 | Worse than 51% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 89 | 88 | 88.12 | Better than 55% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 3 | 3.319 | Better than 55% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 300 cases | 76 | 74 | 74.97 | Better than 59% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 300 cases | 8 | 9 | 9.68 | Better than 60% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 300 cases | 16 | 16 | 15.35 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 80 | 75 | 75.27 | Better than 79% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 3 | 5 | 6.154 | Better than 81% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 300 cases | 17 | 20 | 18.58 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 83 | 77 | 76.85 | Better than 82% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 3 | 4 | 5 | Better than 64% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 300 cases | 14 | 19 | 18.15 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 92 | 86 | 85.92 | Better than 87% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 1 | 3 | 3.094 | Better than 77% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 300 cases | 7 | 11 | 10.98 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 300 cases | 67 | 59 | 65.6 | Better than 75% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 300 cases | 6 | 9 | 7.774 | Better than 70% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 300 cases | 27 | 31 | 26.63 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 87 | 82 | 84.26 | Better than 85% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 3 | 3.821 | Better than 56% 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 · 300 cases | 4 | 5 | 6.017 | Better than 57% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 300 cases | 73 | 71 | 72.87 | Better than 54% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 300 cases | 88 | 87 | 87.21 | Better than 51% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 300 cases | 23 | 23 | 21.12 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 4 | 3.694 | Better than 42% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 300 cases | 52 | 47 | 49.46 | Better than 72% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 300 cases | 24 | 30 | 29.64 | Better than 77% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 300 cases | 24 | 22 | 20.89 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 300 cases | 4 | 3 | 3.266 | Better than 60% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 300 cases | 15 | 12 | 12.55 | Worse than 73% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 300 cases | 85 | 88 | 87.45 | Worse than 73% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | North Texas Medical Center | US median | TX 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 | 6.38 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.192 | |||
| 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 · 572 cases | 90 | 79 | 72.24 | Better than 71% 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 · 386 cases | 123 | 154 | 151 | Better than 77% 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 · 356 cases | 117 | 148 | 146 | Better than 76% 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 | Not Available | 331 | |||
| 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 · 21 cases | 229 | 293 | 279 | Better than 77% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 17,723 cases | 2 | 1 | 1.372 | Worse than 58% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 · 17 cases | 65 | 74 | 69.2 | Worse than 67% of US hospitals | |
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 64 cases | 98 | 97 | 90.54 | Better than 54% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 99.5 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 41.08 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 284 cases | 11 | 15 | 13.94 | Better than 77% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 54 cases | 78 | 65 | 66.54 | Better than 80% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 12 cases | 83 | 73 | 71.35 | Better than 72% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 89.11 | |||
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 54 cases | 91 | 82 | 82.14 | Better than 85% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 39 cases | 92 | 94 | 92.38 | Worse than 61% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 93.64 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 71.67 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 92.48 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 78.56 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 225 cases | 97 | 97 | 93.78 | Better than 45% of US hospitals |
How often scans were ordered when they may not be needed; lower is better.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 6.3 | 5 | 7.719 | Worse than 64% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 8.3 | 6.6 | 6.859 | Worse than 70% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 1.04 | 0.99 | 1.034 | Worse than 75% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 16.67 | 20 | 25.32 | Worse than 56% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 4.167 | 5 | 6.413 | Worse than 57% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 10 | 10 | 6.145 | Better than 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 2.5 | 2.5 | 1.611 | Worse than 44% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 60 | 34 | 39.47 | Better than 86% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 15 | 8.75 | 10.13 | Better than 84% of US hospitals | |
| VBP safety domain scoreFY 2026 | 50 | 40 | 48.35 | Better than 64% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 12.5 | 10 | 12.26 | Better than 64% of US hospitals | |
| VBP total performance scoreFY 2026 | 34.17 | 29.5 | 29.94 | Better than 67% of US hospitals |
| By fiscal year | FY 2021 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 33.33 | 50 | 26.67 | 23.33 | 16.67 |
| VBP clinical outcomes weighted domain score | 11.11 | 12.5 | 6.667 | 7.778 | 4.167 |
| VBP efficiency and cost reduction domain score | 10 | 0 | 0 | 0 | 10 |
| VBP efficiency and cost reduction weighted domain score | 3.333 | 0 | 0 | 0 | 2.5 |
| VBP person and community engagement domain score | 48 | Not Available | 47 | 45 | 60 |
| VBP person and community engagement weighted domain score | 16 | Not Available | 11.75 | 15 | 15 |
| VBP safety domain score | Not Available | Not Available | 0 | Not Available | 50 |
| VBP safety weighted domain score | Not Available | Not Available | 0 | Not Available | 12.5 |
| VBP total performance score | 30.44 | Not Available | 18.42 | 22.78 | 34.17 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.013 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 1.01 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | 0.9907 | 0.9969 | 0.999 | Better than 56% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 0.9774 | 0.9983 | 1 | Better than 65% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | 0.9884 | 0.9916 | 1.006 | Better than 51% of US hospitals | |
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 159 cases | 0.9493 | 0.9955 | 1.003 | Better than 80% 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 | 1.051 | 1.027 | 1.007 | 0.9553 | 0.9512 | 0.9907 |
| READM-30-HF-HRRP | 1.048 | 1.01 | 0.9755 | 0.9655 | 0.9669 | 0.9774 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | 0.9971 | 0.9884 |
| READM-30-PN-HRRP | 1.041 | 1.044 | 1.046 | 1.041 | 1.07 | 0.9493 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | North Texas Medical Center | US median | TX average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.489 | 0.4327 | The best result, shared by 14% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.474 | 0.346 | 0.2562 | Worse than 68% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.559 | 0.5596 | 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 | N/A | 0.6118 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 1.217 | 0.9628 | 0.9684 | Worse than 91% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.7483 | |||
| Total HAC scoreFY 2026 | -0.1894 | -0.0453 | -0.1734 | Better than 60% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | Yes | Yes | N/A | Yes | Yes | No |
| Total HAC score | 0.3847 | 0.395 | 0 | 1.732 | 0.7218 | -0.1894 |
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.
CIHQ (since 2025)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
60
Medicare-certified beds
65
Registered nurses (full-time equivalent)
1976
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What North Texas Medical Center reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
1,633
Inpatient discharges
Medicare 30%, Medicaid 1%
7,297
Inpatient days
57% of available bed days used
279
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 838428). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges North Texas Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 2,850 | 134 | 4,313 | 7,297 |
| Discharges | 483 | 22 | 1,128 | 1,633 |
| Average length of stay | 5.9 days | 6.1 days | 3.8 days | 4.5 days |
| Average daily census | 7.8 | 0.4 | 11.8 | 20.0 |
1,837
Medicare Advantage days
378 discharges
644
Medicaid managed care days
261 discharges
1,122
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 29 | 5,379 | 1,895 | 51% |
| Intensive care unit | 6 | 478 | 253 | 22% |
| Nursery | 421 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What North Texas Medical Center treats Medicare patients for most often, in 2024. 317 Medicare discharges in 13 published DRGs; 4% surgical; 61% 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 | 72 | $45,144 | $15,559 | $17,471 | 1.98 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 50 | $33,247 | $9,765 | $12,866 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 32 | $37,642 | $11,143 | $14,567 | 1.33 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 25 | $21,734 | $6,792 | $8,411 | 0.81 |
| Heart failure and shock with MCCMS-DRG 291, medical | 23 | $32,970 | $10,903 | $12,759 | 1.28 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 23 | $25,308 | $8,317 | $9,794 | 1.03 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 15 | $39,647 | $13,520 | $15,343 | 1.70 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 14 | $24,049 | $9,130 | $9,307 | 1.06 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $23,940 | $7,024 | $9,265 | 0.82 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 13 | $67,293 | $13,949 | $26,042 | 1.88 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 13 | $22,965 | $6,964 | $8,887 | 0.78 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 12 | $28,978 | $9,945 | $11,214 | 1.17 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 11 | $33,556 | $14,448 | $12,986 | 1.79 |
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) North Texas Medical Center billed Medicare for most in 2024: 446 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 244 | 136 | $7,800 | $1,773 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 96 | 91 | $13,380 | $2,080 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 24 | 21 | $7,224 | $1,463 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 17 | 17 | $6,622 | $1,241 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 16 | 16 | $15,518 | $4,431 | $4,358 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 13 | 13 | $13,200 | $2,486 | $2,373 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 13 | 13 | $13,689 | $2,657 | $2,636 |
| Level 3 Vascular ProceduresAPC 5183 | 12 | 12 | $17,077 | $2,448 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 11 | 11 | $35,261 | $5,494 | $5,339 |
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 North Texas 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 725 in 2020 to 759 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 76240 | 497 | 65% | 2,325 | $18.2M | 29% | 42% |
| 76273 | 50 | 7% | 213 | $1.7M | 7% | 7% |
| 76272 | 47 | 6% | 249 | $2M | 17% | 19% |
| 76252 | 38 | 5% | 158 | $1.3M | 28% | 33% |
| 76241 | 36 | 5% | 159 | $1.2M | 53% | 55% |
| 73459 | 26 | 3% | 122 | $929,874 | 39% | |
| 76250 | 17 | 2% | 60 | $453,951 | 40% | 100% |
| 76255 | 17 | 2% | 78 | $617,641 | 5% | |
| 76233 | 16 | 2% | 78 | $590,026 | 7% | 6% |
| 76265 | 15 | 2% | 75 | $613,542 | 16% |
Source: CMS Hospital Service Area file. Shares are of the 759 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 North Texas Medical Center reported at its latest Medicare certification survey (2025). Counts are people, not full-time equivalents.
4
Operating rooms
1
Endoscopy rooms
1
Off-site locations
65
Registered nurses
7
Licensed practical nurses
6
Physicians
3
Pharmacists
9
Respiratory therapists
3
Physical therapists
1
Occupational therapists
1
Speech pathologists and audiologists
11
Radiology technicians
1
Nuclear medicine technicians
6
Laboratory technicians
3
Medical technologists
111
Other personnel
Source: CMS Provider of Services file.
163 clinicians who bill Medicare list North Texas 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.
Susmita Sakruti, M.D
Hematology & Oncology Physician
NPI 1346553187
See commercial rates for Susmita Sakruti, M.DCharles Kurkul, M.D.
Hematology & Oncology Physician
NPI 1134419682
See commercial rates for Charles Kurkul, M.D.Camille Johnson, M.D.
Hematology & Oncology Physician
NPI 1457732711
See commercial rates for Camille Johnson, M.D.Lisa Houk, FNP
Family Nurse Practitioner
NPI 1528282902
See commercial rates for Lisa Houk, FNPSharad Jain, MD
Hematology & Oncology Physician
NPI 1467494385
See commercial rates for Sharad Jain, MDMohammad Qasim, MD
Hematology & Oncology Physician
NPI 1609875087
See commercial rates for Mohammad Qasim, MDJay Bender, M.D.
Orthopaedic Surgery Physician
NPI 1346242278
See commercial rates for Jay Bender, M.D.Muqdad Zuriqat, MD
Specialist
NPI 1417962887
See commercial rates for Muqdad Zuriqat, MDAlmas Syed, M.D.
Diagnostic Radiology Physician
NPI 1821358698
See commercial rates for Almas Syed, M.D.Chris Cianci, D.O.
Interventional Cardiology Physician
NPI 1730496720
See commercial rates for Chris Cianci, D.O.Yao Chen, M.D.
Diagnostic Radiology Physician
NPI 1346566734
See commercial rates for Yao Chen, M.D.Solomon Spiegel, D.O.
Interventional Cardiology Physician
NPI 1871852293
See commercial rates for Solomon Spiegel, D.O.Lyn Ward, M.D.
Orthopaedic Surgery Physician
NPI 1700865060
See commercial rates for Lyn Ward, M.D.Jerry Keaton, M.D.
Diagnostic Radiology Physician
NPI 1699731836
See commercial rates for Jerry Keaton, M.D.Sridhar Iyer, MD
Pulmonary Disease Physician
NPI 1043299712
See commercial rates for Sridhar Iyer, MDLeland Jolgren, M.D.
Diagnostic Radiology Physician
NPI 1275573933
See commercial rates for Leland Jolgren, M.D.Bruce Linder, M.D.
Diagnostic Radiology Physician
NPI 1023189214
See commercial rates for Bruce Linder, M.D.Gary Fazio, M.D.
Cardiovascular Disease Physician
NPI 1255331955
See commercial rates for Gary Fazio, M.D.Mina Tadros, M.D.
Diagnostic Radiology Physician
NPI 1356791206
See commercial rates for Mina Tadros, M.D.Jonathan Church, MD
Pain Medicine (Anesthesiology) Physician
NPI 1598152217
See commercial rates for Jonathan Church, MDRajesh Gogia, M.D.
Diagnostic Radiology Physician
NPI 1679528467
See commercial rates for Rajesh Gogia, M.D.Richard Jolly, M.D.
Ophthalmology Physician
NPI 1376541169
See commercial rates for Richard Jolly, M.D.Christian Vissers, MD
Orthopaedic Surgery Physician
NPI 1174516876
See commercial rates for Christian Vissers, MDKandace Farmer, D.O.
Diagnostic Radiology Physician
NPI 1457322513
See commercial rates for Kandace Farmer, D.O.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 North Texas 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) | $166.7M | 353.4% |
| Inpatient | $52.4M | 111.0% |
| Outpatient | $114.3M | 242.4% |
| Contractual allowances and discounts | -$119.5M | -253.4% |
| Net patient revenue | $47.2M | 100.0% |
| Operating expenses | -$50.2M | -106.5% |
| Operating income from patient care | -$3.1M | -6.5% |
| Other income | $2.3M | 4.8% |
| Net income | -$796,044 | -1.7% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $31.9M | 19.7% |
| Medicaid (including managed care) | $15.8M | 9.8% |
| Other payers and self-pay | $114.2M | 70.5% |
| Total charges | $161.9M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, 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 North Texas Medical Center's latest cost report.
-6.5%
Operating margin
Operating income from patient care / net patient revenue
-1.6%
Total margin
Net income / net patient revenue plus other income
2.8%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
57% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$41.60
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-5.0%
Return on assets
Net income for a year / total assets
-19.5%
Return on equity
Net income for a year / fund balance
1.46
Current ratio
Current assets / current liabilities
1.27
Quick ratio
Cash, temporary investments and net receivables / current liabilities
5 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
68 days
Days in patient receivables
Net patient receivables / daily net patient revenue
55 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
3.13
Asset turnover
Total revenue for a year / total assets
2.2 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What North Texas Medical Center owned and owed at the end of its reporting period (Dec 2025), across all fund types: $15.8M in total assets and a $4.1M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $659,179 | 4.2% |
| Patient receivables, net | $8.8M | 55.4% |
| Inventory | $786,455 | 5.0% |
| Total current assets | $10.8M | 68.4% |
| Property and equipment, net of depreciation | $3.5M | 22.3% |
| Investments and other assets | $1.5M | 9.3% |
| Total assets | $15.8M | 100.0% |
| Current liabilities | $7.4M | 46.9% |
| Total liabilities | $11.7M | 74.2% |
| Fund balance (net assets) | $4.1M | 25.8% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care North Texas Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$4.5M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$4.3M
Bad debt
Patient bills written off as uncollectible, at charges
-$3.1M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$5.6M
Total unreimbursed and uncompensated care
11.2% 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 838428, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
North Texas 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 | $40.5M | $43.8M | $43.4M | $41.5M | $47M | $47.2M |
| Operating expenses | $39M | $44.8M | $44.1M | $46.2M | $49.3M | $50.2M |
| Operating margin | 3.7% | -2.2% | -1.5% | -11.3% | -4.9% | -6.5% |
| Net income | $5.8M | $1M | $1.6M | -$1.8M | $89,274 | -$796,044 |
| Total assets | $18.6M | $20.8M | $16.3M | $15.3M | $15.5M | $15.8M |
| Discharges | 1,359 | 1,392 | 1,463 | 1,575 | 1,679 | 1,633 |
| Inpatient days | 5,829 | 7,004 | 6,936 | 6,668 | 7,223 | 7,297 |
| Medicare Advantage days | 1,185 | 1,525 | 1,857 | 1,903 | 1,836 | 1,837 |
| Beds | 35 | 35 | 35 | 35 | 35 | 35 |
| Employees (FTE) | 238 | 190 | 217 | 231 | 256 | 279 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center North Texas 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 |
|---|---|---|---|---|---|
| Rural health clinic | $2.3M | $5M | $6.2M | 0.81 | 21,394 |
| Emergency | $2.1M | $4.7M | $24M | 0.19 | 9,432 |
| Laboratory | $890,271 | $3.1M | $15.7M | 0.20 | 3,920 |
| Operating room | $1.2M | $2.9M | $15.4M | 0.18 | 15,660 |
| Drugs charged to patients | $2.8M | $15.3M | 0.18 | ||
| Delivery room & labor room | $1.3M | $2.6M | $2.2M | 1.15 | 11,940 |
| Impl. dev. charged to patients | $2.5M | $3.4M | 0.74 | ||
| Ct scan | $2.5M | $25.4M | 0.10 | 5,047 | |
| Medical supplies charged to patient | $1.8M | $2.4M | 0.76 | ||
| Respiratory therapy | $892,540 | $1.6M | $9.9M | 0.16 | 716 |
| Observation beds (non-distinct part | $1.2M | $1.5M | 0.79 | ||
| Physical therapy | $782,838 | $994,130 | $3.2M | 0.31 | 2,034 |
| Recovery room | $358,970 | $672,221 | $2M | 0.34 | 1,736 |
| Radiology-diagnostic | $1.3M | $459,642 | $11.1M | 0.04 | 2,204 |
| Mri | $455,724 | $4.7M | 0.10 | 925 | |
| Cardiac catheterization | $114,912 | $393,928 | $617,508 | 0.64 | 5,170 |
| Occupational therapy | $302,389 | $925,421 | 0.33 | 100 | |
| Sleep lab | $213,635 | 5,643 | |||
| Speech pathology | $114,088 | $351,117 | 0.32 | 100 | |
| Anesthesiology | $31,392 | $3.9M | 0.01 | 192 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $2.7M | $7.2M | $9.6M | 0.75 | 16,388 |
| Intensive care unit | $991,067 | $2.2M | $2.9M | 0.75 | 3,396 |
| Nursery | $48,886 | $128,128 | $1.1M | 0.11 | 1,400 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $4M | $9.8M | 111,143 | $33.66 | 36,087 |
| Employee benefits department | $333,516 | $5.5M | 6,384 | $92.47 | 528 |
| Maintenance & repairs | $280,568 | $1.5M | 9,126 | $30.49 | 15,105 |
| Cap rel costs-mvble equip | $1.4M | ||||
| Pharmacy | $805,061 | $985,689 | 15,702 | $50.85 | 2,128 |
| Dietary | $917,753 | 4,804 | |||
| Cap rel costs-bldg & fixt | $795,301 | 196,650 | |||
| Housekeeping | $776,806 | 631 | |||
| Nursing administration | $749,739 | $759,572 | 11,739 | $63.21 | 468 |
| Medical records & library | $436,409 | $543,267 | 16,680 | $25.40 | 2,171 |
| Central services & supply | $165,504 | $334,067 | 6,653 | $32.75 | 2,894 |
| Laundry & linen service | $106,488 | $167,027 | 6,046 | $16.98 | 1,432 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838428, 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 North Texas Medical Center 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.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
22.2%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
485
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
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 | 1.44 | 1.44 | 1.61 | 1.51 | 1.35 | 1.35 | 1.30 |
| Wage index | 0.949 | 0.955 | 0.953 | 0.933 | 0.936 | 0.972 | 0.991 |
| Readmissions adjustment | -0.95% | -0.93% | -0.74% | -0.04% | -0.36% | -0.61% | 0.00% |
| Value-based purchasing adjustment | -0.37% | -0.05% | -0.05% | +0.33% | -0.25% | +0.04% | +0.36% |
| Medicare inpatient stays | 579 | 579 | 527 | 492 | 484 | 541 | 485 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations North Texas Medical Center reports to Medicare as owners or with operational control. 1 individuals also hold ownership interests; they are not listed here.
Community Hospital Consulting, Inc
5% or greater direct ownership interest, 100%, since 2018
Sources: CMS Hospital All Owners, CMS Hospital Change of Ownership.
The officers and board members on North Texas 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.
Gainesville Community Hospital Inc files the Form 990 for the tax ID insurers list for North Texas Medical Center, so these people may lead the wider organization rather than North Texas Medical Center alone.
| Name | Title |
|---|---|
| Joe Thomason | Director/president |
| Linda Moore | Secretary |
| James Hill | Treasurer |
| Thomas Sledge | CEO |
| Shelle Diehm | CFO (until 12/22) |
| Bonnie Hess | CNO |
| Tania LeMons | CFO (start 12/22) |
Board members: Jim Kendrick, Shane Lee.
Source: IRS Form 990 Part VII filed by Gainesville Community Hospital Inc (EIN 83-1683025), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Not participating
340B ID SCH450090-00, registered as a sole community hospital. Authorizing official: Thomas Sledge, Chief Executive Officer.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Accountable care organization (Medicare Shared Savings Program)
Main Street Rural Health Hickory ACO LLC
ACO A5334, current agreement since 2026. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on North Texas Medical Center's legal name.
Helipad
North Texas Medical Center
FAA location ID 8TX9, a medical-use heliport at the hospital.
Source: FAA National Airspace System Resource data, cycle 2026-10-01.
North texas medical center
CCN 45U090, certified 2006, Medicare prospective payment
Ntmc health complete care
CCN 458896, certified 2010, Medicare cost reimbursed
Source: Worksheet S-2 Part I of North Texas Medical Center's latest Medicare cost report (HCRIS).
About North Texas Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at North Texas Medical Center range from $792 to $2,673 across 4 insurers. Cigna's rate is $1,724. The median at nearby comparable hospitals is $1,951. 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 North Texas Medical Center range from $1,010 to $2,323 across 4 insurers. Aetna's rate is $1,566. The median at nearby comparable hospitals is $2,239. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at North Texas Medical Center range from $760 to $1,634 across 4 insurers. UnitedHealthcare's rate is $1,538. The median at nearby comparable hospitals is $2,288. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at North Texas Medical Center range from $3,528 to $4,290 across 2 insurers. Blue Cross Blue Shield's rate is $4,290. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at North Texas Medical Center range from $138 to $319 across 4 insurers. UnitedHealthcare's rate is $319. The median at nearby comparable hospitals is $271. What a patient pays depends on their plan's deductible, coinsurance and network status.
North Texas Medical Center has a CMS overall hospital star rating of 4 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is higher than 58% of US hospitals.
CMS reports no Medicare-funded interns or residents at North Texas Medical Center for fiscal year 2027.
No. North Texas Medical Center has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (72 discharges), pulmonary edema and respiratory failure (50 discharges), simple pneumonia and pleurisy with mcc (32 discharges).
North Texas Medical Center's Medicare case mix index is 1.30 for fiscal year 2027, higher than 11% of hospitals paid under the inpatient prospective payment system.
North Texas Medical Center reported 1,633 inpatient discharges and 7,297 inpatient days from Jan 1, 2025 to Dec 31, 2025.
North Texas Medical Center reported 279 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
North Texas Medical Center reported $47.2M in net patient revenue on $166.7M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of -6.5%, and net income of -$796,044.
North Texas Medical Center reported $5.6M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $4.5M of charity care at cost.
North Texas Medical Center's Medicare enrollment lists Thomas R Sledge as Chief Executive Officer since 2018.
Insurers' price transparency files list North Texas Medical Center under employer identification number 83-1683025 (North Texas Medical Center). 55 health plans and networks list 83-1683025 for it.
HRSA's 340B database lists North Texas Medical Center (340B ID SCH450090-00) as no longer participating since 2023.
163 clinicians who bill Medicare list North Texas Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (25), diagnostic radiology physician (19), family medicine physician (18).
Yes. CMS's Provider of Services file lists CIHQ as the accrediting organization for North Texas Medical Center, effective 2025.
In its Medicare enrollment, North Texas Medical Center reports Community Hospital Consulting, Inc as 5% or greater direct ownership interest (100%).
CMS lists 28 services at North Texas Medical Center, including Anesthesia, Clinical Laboratory, CT Scan, Dental Care, Designated Trauma Center, Diagnostic Radiology.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at North Texas Medical Center came from ZIP codes 76240 (497), 76273 (50), 76272 (47).
North Texas Medical Center has 35 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 60 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
North Texas Medical Center is located at 1900 Hospital Boulevard, Gainesville, TX 76240. Its main phone number is (940) 612-8600.
North Texas Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 450090.
The National Provider Identifier (NPI) on file for North Texas Medical Center is 1972071991.
North Texas Medical Center is affiliated with SSM Health.
North Texas Medical Center lists 32 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
335 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