What is the difference between payer-posted and hospital-posted price transparency data?
Payer-posted data is part of the Transparency in Coverage (TiC) Rule - read more from CMS HERE.
Hospital-posted data is part of Hospital Price Transparency (HPT) Rule - read more from CMS HERE.
Each rule has its own requirements in terms of what data must be included. We have created a quick reference table below to summarize the requirements of each dataset:
| Payer-Posted Data (TiC) | Hospital-Posted Data (HPT) | |
| Data Update Frequency | Monthly | Annually |
| Commercial Rates | Yes | Yes |
| ACA / Exchange Rates | Yes | Yes |
| Managed Medicaid Rates | No | Yes |
| Medicare Advantage Rates | No | Yes |
| Cash Pay Rates | No | Yes |
| Institutional Fees | Yes | Yes |
| Professional Fees | Yes | No |
| ASC Fees | Yes | No |
| Billed Charges | No | Yes |
| In-Network Rates | Yes | Yes |
| Out-of-Network Rates | Yes (via separate files) | No |
| Relevant Serif Health 'Signal' Modes | MRF Rate Search Market Benchmarks Peer Benchmarks |
Hospital Rate Search |