Learn · Nov 10, 2026 · Not legal advice
Out-of-network bill from an in-network hospital: what the No Surprises Act covers
The No Surprises Act limits what you can be charged for emergency care and for certain non-emergency services from out-of-network providers at in-network facilities. Before paying, ask whether your bill is covered and compare it with your EOB.
What it generally covers
- Emergency services, including at out-of-network facilities.
- Certain non-emergency services from out-of-network providers at an in-network hospital or surgery center, such as anesthesia or radiology.
In covered cases, you generally owe only your in-network cost-sharing amount.
Exceptions
A provider can sometimes ask you to sign a notice and consent to out-of-network care. Read what you signed before you assume the protection applies. Ground ambulance bills were not covered when we last checked, so verify the current rules.
What to do
My EOB shows this provider as out-of-network at an in-network facility. Can you confirm whether this bill is subject to the No Surprises Act protections, and send an itemized statement?
If they say it isn’t covered or you disagree, CMS runs a help line for these bills: 1-800-985-3059.
Common questions
Does this apply if I have no insurance?
Uninsured and self-pay patients have separate rights, including the good faith estimate.