No Surprises Act Cost-Share (QPA-Based)

No Surprises Act cost-share: the protected patient cost-share on the QPA and the prohibited balance-bill amount for an emergency/out-of-network claim.

Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Service category under the No Surprises Act
Protected: emergency service
Qualifying Payment Amount
800 $
Billed charge
1000 $
In-network coinsurance percentage
20

Result: Protected emergency: patient cost-share $160.00 (20% of the $800.00 QPA); plan pays $640.00; $200.00 balance bill prohibited.

The tool opens with these values already filled in. Replace them with your own.

What you enter

  • Service category under the No Surprises Act
  • Qualifying Payment Amount (QPA)
  • Billed charge (for the prohibited balance-bill amount)
  • In-network coinsurance percentage
How this is calculated

No Surprises Act (PHS Act §2799A-1/§2799A-2; 45 CFR Part 149): for protected out-of-network emergency and certain ancillary services at in-network facilities, the patient cost-share is computed as if in-network off the QPA, and balance billing is prohibited. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.