Simplify compliance with the new price transparency rules 

New price transparency rules are coming at hospitals and health systems fast and furious, placing added reporting and compliance burdens on your healthcare provider organization. But Kodiak can lighten your reporting and compliance load with easily accessible EDI data if you’re a Kodiak Platform user. 

As you likely know by now, the Centers for Medicare & Medicaid Services published its final Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems rules on Nov. 25, 2025, in the Federal Register. The new rules place additional public price reporting requirements on hospitals. The new requirements take effect on Jan. 1, 2026, but CMS won’t enforce them until April 1, 2026. 

That gives your organization only three short months to prepare before compliance becomes mandatory. 

The new rules require hospitals to post in machine-readable files the median allowed prices payors paid for services provided by the hospital and those same allowed prices at the 10th and 90th percentiles. The three price points replace one estimated allowed amount for each service. 

“These changes aim to improve transparency in hospital pricing, facilitate efficient enforcement of the HPT (hospital price transparency) requirements, and empower consumers with actionable pricing information,” CMS said. 

The new rules require hospitals to use 835 electronic remittance advice EDI data from their payors (or an unspecified alternative) to calculate the median, 10th percentile, and 90th percentile allowed amounts to post on their websites in MRFs. Not all hospitals or their revenue cycle vendors have 835 ERA data easily available at their fingertips if at all. 

CMS estimated the nationwide one-time cost to all hospitals of complying with the new requirements at nearly $11 million, or about $1,500 per hospital.  

“We believe that the benefits to the public (and to hospitals themselves) outweigh the burden improved on hospitals,” CMS said. 

For the 2,300 hospitals that use the Kodiak Platform to manage and report their net revenue and monitor their revenue cycle performance, the burden and cost of compliance will be significantly less.  

Why? Kodiak already has 835 ERA data for every hospital Kodiak Platform user. Every Kodiak Platform user routinely transmits 835 ERA data to Kodiak each month as part of their data transfer to the Kodiak Platform. It’s your data, and we have it stored in an easily accessible place. No need to search for it. No need to pay an outside vendor to find it for you.  

Our mission at Kodiak is to simplify the business of healthcare. One way we do that is with data. This is a perfect example of that mission and execution in action. By partnering with Kodiak, you can act on data in real time for smarter operations. 

Hit the easy button. Make compliance with CMS’ new hospital price transparency requirements easy with your own 835 ERA data from Kodiak.