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At or below 250% of FPL 100% discount
251% - 350% of FPL 85% discount
351% - 400% of FPL 75% discount
The Amount Generally Billed or “AGB” is calculated annually using a “look back method” based on Medicare fee-for-service rates, including Medicare beneficiary cost-sharing amounts and all private health insurers that paid hospital and professional claims for the prior fiscal year. The sum of these total payments is then divided by the sum of total charges to identify the “AGB percentage.” The AGB percentage for fiscal year 2020 is 60.15%. The discounts listed above are applied after applicable charges have been reduced by 60.15%. This analysis is completed, and the AGB percentage may be revised, on an annual basis.
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