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Chart for Determining the Applicability for the Federal Independent Dispute Resolution (IDR) Process

Guidance for disputing parties that provides a high-level summary to assist in determining whether the Federal Independent Dispute Resolution (IDR) process or a state law or All-Payer Model Agreement applies for determining out-of-network rates.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 13, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.