CMS Price Transparency Data

Community mental health services

Facility: Boston Medical Center

Billing Code: H0038 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: H0038
Insurance Median: $7
Cash Discount Price: $5
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Community mental health services at Boston Medical Center is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$4	N/A
Zzzcity of Boston Work Comp [5003]	$5	N/A
Uphams Corner Esp [1213]	$5	N/A
Workers Comp [5002]	$5	N/A
Zzzbu Employee Work Comp [5004]	$5	N/A
Mass General Brigham Health Plan Commercial [8009]	$6	N/A
Zzzunited [1008]	$6 - $7	N/A
Health Plans Inc [2027]	$6	N/A
Zzzhealth Plans Inc [1013]	$6	N/A
Aetna	$6	N/A
Harvard Pilgrim Health Care [8001]	$6	N/A
United [2025]	$6 - $7	N/A
Meritain Health [1023]	$6	N/A
UnitedHealthcare	$7	N/A
Oxford Health [2024]	$7	N/A
Oxford Health [1007]	$7	N/A
Unicare [8004]	$9	N/A
Cigna	$9 - $10	N/A
Wellpoint [2034]	$9	N/A
Tufts [8002]	$9 - $10	N/A
Tufts Conncare/Qhp [8020]	$27 - $28	N/A
Hsn Bad Debt [4003]	$513	N/A
Hsn Confidential [4007]	$513	N/A
Hsn Partial [4002]	$513	N/A
Hsn [4001]	$513	N/A
Hsn Dental [4006]	$513	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $5.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: H0038.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code H0038.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.