Providers
Know the cost of a covered item or service prior to receiving care. As required by federal and state authorities, below are links to the machine readable files for use by provider agencies.
• CFR § 2590.715-2715A3
• Tex. Ins. Code § 1662.101
In-Network Rates
The file includes a billing code, and a plain language description for each and negotiated rates.
Out-of-network allowed amount
The file includes a billing code, and a plain language description for each; and each unique out-of-network allowed amount is:
- Reflected as a dollar amount, with respect to each covered item or service that is furnished by an out-of-network provider; and
- Associated with the NPI, TIN, and Place of Service Code for each out-of-network provider.
New York Providers Only
Link to MVP (third-party site) with Machine Readable Files for Farm Family Medical Plans.
