The two dates, read off the rules rather than off a summary
45 CFR part 180, Hospital Price Transparency, was created by a Centers for Medicare and Medicaid Services final rule numbered CMS-1717-F2 and published at 84 FR 65524 on November 27, 2019. Its DATES section reads "This final rule is effective on January 1, 2021."[2] The part’s own source note in the Code of Federal Regulations is 84 FR 65602 of the same date, and its authority is 42 U.S.C. 300gg-18 and 42 U.S.C. 1302[4].
45 CFR part 149, Surprise Billing and Transparency Requirements, came out of an interim final rule titled Requirements Related to Surprise Billing; Part I, published jointly by four federal bodies at 86 FR 36872 on July 13, 2021. Its DATES section separates two things that are easy to conflate: the regulations became effective on September 13, 2021, and are generally applicable for plan years, or in the individual market policy years, beginning on or after January 1, 2022, with the provisions that apply to health care providers, facilities and air ambulance providers applicable beginning January 1, 2022[3]. The part’s source note is 86 FR 36970[5].
The two rules answer different questions and are worth keeping apart. Part 180 is about publication and takes effect before anybody is treated: it says what a hospital has to put on the internet, and it implements section 2718(e) of the Public Health Service Act[2]. Part 149 is about billing and takes effect afterwards: it says what a patient may be charged, and its authority runs from 42 U.S.C. 300gg-92 and 300gg-111 through 300gg-139[5].
What a hospital has to publish
Section 180.40 requires two separate things, and they are easy to mistake for each other. The first is a machine-readable file containing a list of all standard charges for all items and services, under 180.50. The second is a consumer-friendly list of standard charges for a limited set of shoppable services, under 180.60[4]. Standard charge is a defined term and it is plural in effect: it takes in the gross charge, the payer-specific negotiated charge, the de-identified minimum and maximum negotiated charges and the discounted cash price.
Section 180.60 sets the size of the consumer-facing list. A hospital must display as many of the 70 shoppable services specified by the agency as it provides, plus as many services of its own choosing as are needed for a combined total of at least 300[4]. From July 1, 2024, section 180.50 also requires the hospital to affirm that the information in its machine-readable file is true, accurate and complete as of the date indicated in the file. That affirmation is the hospital’s, not the agency’s and not this publication’s.
How many Kansas hospitals this reaches depends on which list is being used. The federal Hospital General Information file, last modified July 22, 2026, holds 139 Kansas rows, of which 83 are critical access hospitals and 44 are acute care hospitals[1]. It is a count of hospitals registered with Medicare. A facility taking neither Medicare nor Medicaid is licensed by the state and is not in it.
| Hospital type | Kansas rows |
|---|---|
| Critical access hospitals | 83 |
| Acute care hospitals | 44 |
| All other types together | 12 |
| All Kansas rows | 139 |
What may not be billed, and the coverage that is exempt
Part 149 carries the balance billing protections in two places that answer two different situations. Section 149.110 covers emergency services. Section 149.120 covers non-emergency services performed by nonparticipating providers at certain participating health care facilities, which is the case of the in-network hospital and the out-of-network anaesthetist[5].
Section 149.20 sets the reach. The regulations apply to group health plans and to health insurance issuers offering group or individual coverage, grandfathered plans included, with exceptions for excepted benefits, short-term limited duration insurance and health reimbursement arrangements[5]. The middle exception is live in Kansas: short-term limited duration policies are sold here, and following federal guidance issued on August 7, 2025 they may run six or twelve months with one renewal to a maximum duration of twenty-four months under K.S.A. 40-2,193(a)(2)[6]. The Insurance Department also records that these policies may be medically underwritten and that the end of one does not open a special enrollment period.
The department goes on to set out what that means in sequence, and it is the part worth holding on to: somebody whose short-term policy ends and who cannot pass medical underwriting for another waits for the next open enrollment period, and their major medical coverage does not take effect until the January 1 that follows[6]. A qualifying life event is the only thing that shortens that wait.
If nobody is insuring the bill
Section 149.610 covers the uninsured and the self-pay. It requires a good faith estimate of expected charges, either on request or on scheduling an item or service. The convening provider or facility has to establish whether the person is uninsured, tell them in writing and orally that an estimate is available, treat a conversation about cost as a request for one, contact co-providers for their expected charges, and furnish the estimate inside periods keyed to how far ahead the service was scheduled or when it was asked for[5].
Where the figures are, and one this page could not get
There are no prices on this page on purpose. Every price a Kansas hospital charges sits in that hospital’s own machine-readable file, published under its own name at its own address, and republishing a figure out of one of those files without saying which day it was read is how a stale charge becomes a fact.
One thing that would have belonged here is missing. The agency publishes its own account of hospital price transparency enforcement, and every request made to that page for this piece returned HTTP 403, as did the agency’s No Surprises Act enforcement page. Nothing about Kansas compliance or Kansas enforcement is stated here as a result. The regulations themselves came instead from the Government Publishing Office, which serves both the Code of Federal Regulations and the Federal Register without complaint[4]. Enforcement is the agency’s to publish and a reader who needs it should ask the agency. A reader who wants the other four sections will find them from Health for Kansas, and each one names its documents the way this page names 45 CFR 180 and 45 CFR 149.