---
kind: "section"
citation: "42 U.S.C. § 300gg–131"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300gg–131"
heading: "Balance billing in cases of emergency services"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300gg-131"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXV — Requirements Relating to Health Insurance Coverage"
  - "Part E — Health Care Provider Requirements"
---

# §300gg–131. Balance billing in cases of emergency services

- (a) **In general—** In the case of a [participant](/usc/42/300gg–91.md?p=d-11), [beneficiary](/usc/42/300gg–91.md?p=d-2), or enrollee with benefits under a [group health plan](/usc/42/300bb–8.md?p=1) or group or [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) offered by a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) and who is furnished during a plan year beginning on or after January 1, 2022, emergency [services](/usc/42/201.md?p=a) (for which benefits are provided under the plan or coverage) with respect to an emergency medical condition with respect to a visit at an emergency department of a [hospital](/usc/42/300s–3.md?p=1) or an independent freestanding emergency department—
  - (1) in the case that the [hospital](/usc/42/300s–3.md?p=1) or independent freestanding emergency department is a nonparticipating emergency facility, the emergency department of a [hospital](/usc/42/300s–3.md?p=1) or independent freestanding emergency department shall not bill, and shall not hold liable, the [participant](/usc/42/300gg–91.md?p=d-11), [beneficiary](/usc/42/300gg–91.md?p=d-2), or enrollee for a payment amount for such emergency [services](/usc/42/201.md?p=a) so furnished that is more than the cost-sharing requirement for such [services](/usc/42/201.md?p=a) (as determined in accordance with clauses (ii) and (iii) of [section 300gg–111(a)(1)(C) of this title](/usc/42/300gg–111.md?p=a-1-C), of [section 9816(a)(1)(C) of title 26](/usc/26/9816.md?p=a-1-C), and of [section 1185e(a)(1)(C) of title 29](/usc/29/1185e.md?p=a-1-C), as applicable); and
  - (2) in the case that such [services](/usc/42/201.md?p=a) are furnished by a nonparticipating [provider](/usc/42/299b–21.md?p=8), the [health care provider](/usc/42/300aa–33.md?p=1) shall not bill, and shall not hold liable, such [participant](/usc/42/300gg–91.md?p=d-11), [beneficiary](/usc/42/300gg–91.md?p=d-2), or enrollee for a payment amount for an emergency [service](/usc/42/201.md?p=a) furnished to such individual by such [provider](/usc/42/299b–21.md?p=8) with respect to such emergency medical condition and visit for which the individual receives emergency [services](/usc/42/201.md?p=a) at the [hospital](/usc/42/300s–3.md?p=1) or emergency department that is more than the cost-sharing requirement for such [services](/usc/42/201.md?p=a) furnished by the [provider](/usc/42/299b–21.md?p=8) (as determined in accordance with clauses (ii) and (iii) of [section 300gg–111(a)(1)(C) of this title](/usc/42/300gg–111.md?p=a-1-C), of [section 9816(a)(1)(C) of title 26](/usc/26/9816.md?p=a-1-C), and of [section 1185e(a)(1)(C) of title 29](/usc/29/1185e.md?p=a-1-C), as applicable).
- (b) **Definition—** In this section, the term “visit” shall have such meaning as applied to such term for purposes of [section 300gg–111(b) of this title](/usc/42/300gg–111.md?p=b).

## Source credit

(July 1, 1944, ch. 373, title XXVII, § 2799B–1, as added Pub. L. 116–260, div. BB, title I, § 104(a), Dec. 27, 2020, 134 Stat. 2824.)