Shoppable services are the 70 items and services CMS selected as ones patients commonly shop for before receiving care — like imaging, lab tests, and office visits. Hospitals must publish standard charges for each in a consumer-friendly format, plus negotiated rates in the machine-readable file.
The list spans imaging (CT, MRI, ultrasound, X-ray), laboratory tests, evaluation and management visits, surgical procedures, and emergency services. Each is identified by a specific HCPCS or CPT code that must match exactly.
Each shoppable service entry must show: a plain-language description, the billing code, the gross charge, the discounted cash price, and payer-specific negotiated rates. The consumer-friendly format should be easily searchable — not a giant undifferentiated table.
Hospitals fail most often by: publishing fewer than 70 services, using non-standard descriptions that don't map to CMS codes, omitting cash prices, or listing services only in the machine file and not in a consumer-friendly format.
Each missing or mislabeled shoppable service is a potential violation. At $5,500 per day, ten gaps across one month equal $1.65M in standing exposure.
A proper compliance audit verifies all 70 services exist, codes match CMS's published list, descriptions are consumer-friendly, and prices are current.
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