Surprise medical bill checker

Emergency care

CMS says that if your health insurance covers emergency care, the hospital, the providers treating you there, and an air ambulance provider cannot charge you more for emergency medical services than your in-network cost-sharing amount. (CMS, Know your rights with insurance (page last modified 08/25/2026))

“A nonparticipating emergency facility must not bill, and must not hold liable, the participant, beneficiary, or enrollee for a payment amount for such emergency services”
45 C.F.R. § 149.410(a)(1)

A group health plan or health insurance issuer that covers emergency department services must cover emergency services without requiring prior authorization, even if the services are out-of-network. (45 C.F.R. § 149.110(b)(1))

CMS says providers are not allowed to ask you to give up your No Surprises Act protections for emergency services in the emergency room (notice and consent can only come up for post-stabilization services after an emergency). (CMS, Know your rights with insurance (page last modified 08/25/2026)) After you are stable, the rules for later care change: For post-stabilization services after an emergency, notice and consent can only be used if (among other conditions) the treating provider determines the patient can travel by nonmedical or nonemergency medical transportation to an available in-network provider or facility within a reasonable distance. (45 C.F.R. § 149.410(b)(1)).

Out-of-network providers at an in-network hospital

An out-of-network provider who furnishes covered non-emergency items or services during a visit at an in-network health care facility must not bill a covered person more than the in-network cost-sharing amount, unless the provider validly satisfies the notice-and-consent criteria (where those are allowed). (45 C.F.R. § 149.420(a))

Out-of-network providers at in-network facilities cannot use notice and consent to waive protections for ancillary services: emergency medicine, anesthesiology, pathology, radiology and neonatology; assistant surgeons, hospitalists and intensivists; diagnostic services including radiology and lab; and services when no in-network provider at the facility can furnish them. (45 C.F.R. § 149.420(b)(1))

“(i) Items and services related to emergency medicine, anesthesiology, pathology, radiology, and neonatology, whether provided by a physician or non-physician practitioner; (ii) Items and services provided by assistant surgeons, hospitalists, and intensivists; (iii) Diagnostic services, including radiology and laboratory services; and (iv) Items and services provided by a nonparticipating provider if there is no participating provider who can furnish such item or service at such facility.”
45 C.F.R. § 149.420(b)(1)

Notice and consent also cannot be used to waive protections for items or services furnished because of unforeseen, urgent medical needs that arise at the time of care. (45 C.F.R. § 149.420(b)(2))

For protected non-emergency services from an out-of-network provider at an in-network facility, the plan or issuer must count the person's cost-sharing payments toward in-network deductibles and in-network out-of-pocket maximums. (45 C.F.R. § 149.120(c)(5))

When a consent form counts

Where an appointment is scheduled at least 72 hours in advance, the written notice for notice-and-consent must be given no later than 72 hours before the services. (45 C.F.R. § 149.420(c)(1)(iii)(A)) If the notice is provided on the same day as the services, it must be provided no later than 3 hours before the services subject to notice and consent. (45 C.F.R. § 149.420(c)(1)(iii)(B))

The written notice must clearly state that consenting to care from the out-of-network provider is optional and that the patient may instead seek care from an available in-network provider. (45 C.F.R. § 149.420(d)(4))

Air ambulance

If a plan or issuer covers air ambulance services, cost-sharing for out-of-network air ambulance services must be the same as it would be for an in-network air ambulance provider. (45 C.F.R. § 149.130(b)(1)) An out-of-network air ambulance provider must not bill or hold a covered person (with group or individual coverage that provides air ambulance benefits) liable for more than the in-network cost-sharing amount. (45 C.F.R. § 149.440(a))

Who is not covered

• CMS says ground ambulance services generally are not covered by the No Surprises Act billing protections (unless state law has different rules) and may still charge out-of-network rates. (CMS, Know your rights with insurance (page last modified 08/25/2026))
• CMS says services covered by short-term limited duration plans, health care sharing ministry plans, and fixed indemnity excepted benefits plans (like hospital indemnity insurance) are not subject to the No Surprises Act billing protections. (CMS, Know your rights with insurance (page last modified 08/25/2026))
• CMS says the balance billing protections generally do not apply to vision-only and dental-only insurance plans, but may apply if vision or dental benefits are included in a health plan. (CMS, Know your rights with insurance (page last modified 08/25/2026))
• CMS lists Medicare, Medicaid, Indian Health Services, VA Health Care and TRICARE under 'Exceptions' on its insurance-rights page and says those programs already protect people from some unexpected out-of-network bills; CMS still offers help with billing issues for people in those programs. (CMS, Know your rights with insurance (page last modified 08/25/2026))

If you were billed anyway

CMS lists the No Surprises Help Desk phone number as 1-800-985-3059, for help submitting a complaint or finding next steps, with help in English, Spanish and over 350 other languages. (CMS, Submit a complaint (page last modified 09/19/2026)) CMS says the No Surprises Help Desk can review whether your insurer, provider or facility followed surprise billing rules, investigate compliance with federal rules under its jurisdiction, and refer complaints to other federal or state enforcement authorities if needed. (CMS, Submit a complaint (page last modified 09/19/2026))

The CFPB says the FDCPA's ban on misrepresentations means a debt collector cannot misrepresent that you must pay a debt arising from a charge exceeding what the No Surprises Act permits. (CFPB, Ask CFPB: What should I know about debt collection and credit reporting if my medical bill was sent to collections? (last reviewed Jul. 25, 2025; page last modified Aug. 4, 2025))

Common questions

Does the No Surprises Act cover ground ambulances?

CMS says ground ambulance services generally are not covered by the No Surprises Act billing protections (unless state law has different rules) and may still charge out-of-network rates. (CMS, Know your rights with insurance (page last modified 08/25/2026))

Can a hospital make me sign away my protections?

Not for emergency care, and not for ancillary services such as anesthesia or radiology at an in-network facility. Out-of-network providers at in-network facilities cannot use notice and consent to waive protections for ancillary services: emergency medicine, anesthesiology, pathology, radiology and neonatology; assistant surgeons, hospitalists and intensivists; diagnostic services including radiology and lab; and services when no in-network provider at the facility can furnish them. (45 C.F.R. § 149.420(b)(1))

Where do I complain about a surprise bill?

CMS says you can submit a No Surprises complaint online (the 'Get Started' form linked from the CMS complaint page) or over the phone at 1-800-985-3059. (CMS, Submit a complaint (page last modified 09/19/2026))