OON pricing with allowed amount as '0'

[ABPhase2]

CMS does not have any recommendation on whether or not to report any OON pricing with allowed amounts that are $ 0.

In such scenario, do we report or remove the code that has allowed amount = '0' ?

[shaselton-usds]

The data around the billed_charges would be lost even if the allowed amount is zero. It is still required.

[bryanbriegel]

@shaselton-usds - the Transparency in Coverage rule notes at: https://www.federalregister.gov/d/2020-24591/p-684

"The Departments further clarify that plans and issuers are only required to include in the Allowed Amount File those covered items and services furnished by an out-of-network provider for which the plan or issuer has adjudicated claims and determined it will pay an allowed amount. If the plan or issuer has not adjudicated claims and determined it will pay an allowed amount for items or services furnished by an out-of-network provider, the plan or issuer is not required to include those allowed amounts or billed charges in the Allowed Amount File.