Does the hospital post what the Wellness contract says?

The table lists 8,392 outpatient, lab, therapy and emergency codes with a facility rate. Across the 26 files that list Wellness, 6,646 of those codes are posted, and 6,457 of them are at the contract rate. Every code that differs is a drug; every other code is at the contract rate. Each hospital posts only the codes it bills, so the counts differ by hospital. The rates do not: 7,722 of the 7,722 codes posted for Wellness carry the same rate in every file that lists them. That is one table at every hospital, as the contract says.

The emergency visit codes show why the check uses every facility rate in the table. The table lists each emergency level twice: as an emergency room case rate ($600 to $5,475) and as an outpatient line ($219.90 to $1,591.20). The files post the case rates.

4 files list no Wellness rows: Emergency Medical Center, Cedar Park; Heart and Vascular Hospital, Waxahachie; Medical Center, Frisco at PGA Parkway; Pavilion, Temple. Counts are distinct codes. One column counts the codes the table does not list or prices only for physicians.

The contract pays a case rate for each Medicare Severity Diagnosis Related Group (MS-DRG). The published table follows a formula: for 664 of its 748 MS-DRGs, the rate is Medicare's FY2025 weight times $18,176.47, within 0.1%. A second base, $24,787, fits 46 of the other 84.

The files use the same base on Medicare's FY2026 weights: 668 of the 757 MS-DRGs they post are the FY2026 weight (before the cap described below) times $18,176.47, within 0.1%. Of the 745 MS-DRGs that the table prices and the files post, 743 differ from the table, and for all 743 the posted rate divided by the table rate equals the change in the weight, within 0.2%. The two that match have the same weight in both years.

The contract does not say which year's weights apply. Medicare updates the weights every October 1; the FY2027 weights took effect on October 1, 2026, after these files were posted.

For 27 of the 743, Medicare's weight fell by more than 10%, and Medicare applies a cap that limits the cut to 10%. The files use the weight before the cap for these, so their rates are lower than a capped weight would give. They are listed here. The files also post rates for 12 MS-DRGs that the table lists without a rate ("n/a"), among them transplants and long ventilation stays.

The contract's rate sheet is dated December 1, 2025, and the contract was amended March 1, 2026. The Baylor Scott & White files are dated June 3, June 12, June 13 and June 29, 2026. Weights: CMS IPPS final rule Table 5. The table matches the FY2025 weights with the 10% cap applied; the files match the FY2026 weights before the cap.

The contract's rate sheet says: "Drugs are billed at the rate of ASP + 10%." The table also lists a dollar rate for many drug codes. Of the 189 outpatient codes whose posted rate differs from the table, all 189 are drugs, and for 188 of them the file is lower.

The files post Medicare's April 2026 payment limit for the drug times 1.10, within 0.5%: 187 of the 189 drugs that differ from the table, 240 of the 241 drugs the table does not list, and 2 of the 2 drugs posted at the table rate. Over all 432 drug codes, the posted rate is a median 1.0000 times the limit times 1.10 (half between 0.9995 and 1.0002). Medicare's limit is ASP + 6% for most drugs, so the rule the files follow is ASP x 1.06 x 1.10.

The table's own rates for the drugs that differ are a median 2.31 times that rule. This page does not settle whether "ASP" in the rate sheet means the average sales price or Medicare's payment limit. The rate sheet has a drug note and a table. This page does not say which governs.

The files post 11 codes at $157.00 that the table prices only under "physician". The files' rows are facility rows, and the table has no facility rate for these codes. Where a code has both a physician line and a therapy line, the files post the therapy rate.

The files post a Wellness rate for 308 codes, 241 of them drugs, that the table does not list. Attachment B says a code that existed on the contract's effective date but is not in the table is paid $0.00, and a code introduced later is paid at invoice cost plus 10%. 240 of the 241 drugs follow the drug rule above. The files do not say which term each rate comes from, so this page counts these codes and does not judge them.

The Wellness contract with Children's Health (C036) works differently from Baylor's. It lists dollar rates for scheduled outpatient services (scans, sleep studies, outpatient surgery) and pays other facility services at 68% of billed charges. Children's posts Wellness as the payer "MCC Health", plan "Commercial", in both of its hospital files.

• Children's Medical Center Dallas. 63 of the 63 scheduled codes are posted with a dollar rate, 63 of them at the contract rate. 19,266 rows are posted at a percentage of billed charges, all at 68%; 19,266 of them carry the note "No services performed during 15-month lookback period."
• Children's Medical Center Plano. 63 of the 63 scheduled codes are posted with a dollar rate, 63 of them at the contract rate. 18,728 rows are posted at a percentage of billed charges, all at 68%; 18,728 of them carry the note "No services performed during 15-month lookback period."

The Children's files do not give a file date. A row at a percentage of billed charges also carries the hospital's estimate in dollars (68% of its gross charge); this page does not use those estimates. The note is the hospital's own: it says the hospital performed none of that service for this payer in the 15 months before it posted the file.

Each posted Wellness rate that differs from the contract table, that the table does not list, or that the table prices only for physicians, by hospital and code. The CSV download also has every rate posted at the contract rate.

• Hospital files: every machine-readable standard charge file listed in Baylor Scott & White's and Children's Health's cms-hpt.txt, 32 files, fetched October 22, 2026 (Mountain time). The two lists: Baylor Scott & White and Children's Health. Rows kept: every row for the Wellness payer, under the name each system uses ("Mark Cuban" at Baylor Scott & White, "MCC Health" at Children's Health).
• Contracts, as published on costpluswellness.com: Baylor Scott & White (C010, Attachment B and the MCC UB-04 Rates Table) and Children's Health (C036, Outpatient Compensation Schedule).
• Matching: by code, within 5 cents, against every facility rate the table lists for the code (outpatient, lab, therapy and emergency lines; MS-DRG for inpatient stays). The files' rows are facility rows, so the table's physician lines are not used. Identical lines count once. Rows whose notes say the hospital performed none of the service, or whose count is 0, are left out: 37,994 rows, all of them Children's Health rows at a percentage of billed charges, counted in the Children's Health section.
• Drugs: the codes in the CMS Medicare Part B payment limit file for April 2026 (the file updated September 15, 2026). The drug rule is tested within 0.5% or 1 cent. MS-DRG weights: CMS IPPS final rule Table 5, FY2025 and FY2026, before and after the 10% cap; base rates within 0.1%, weight ratios within 0.2%.
• The build renders this whole page, and its downloads, from a template and the data, and requires the published files to match that rendering exactly. A tamper test confirms that edits to the page stop the build.

What this can and cannot say. A posted rate is what the hospital says it has negotiated with the payer. It is not a claim or a payment. Where a file and the published contract differ, this page does not show which one Wellness pays: the contract could have a later rate sheet that is not published, or the parties could read an open term the same way the files do. This page says nothing about the quality of care at any hospital.