Transparency in Coverage

The Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, went into effect July 1, 2022.  The Rule requires health insurance companies to provide cost information to the public about medical services covered under their health insurance plans.

The link below leads to the machine readable files that are made available to plan members and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.