Price Transparency Machine-Readable Files Field Reference

Transparency in Coverage (TiC) machine-readable files (MRFs) contain a standardized set of fields. Below are the key elements you’ll see most often:

• Reporting Entity (Payer) – The insurer or plan administrator publishing the file.

• Plan Name / ID – Identifies the health plan the rates apply to.

• Negotiation Type – The type of contract (e.g., fee-for-service, bundled).

• Billing Code – CPT®, HCPCS, or DRG code used for the service or item.

• Description – Human-readable description of the billing code.

• Provider Reference – Links to provider details (typically an NPI or Tax ID).

• Service Location – Place of service indicator code (eg, office 11, inpatient 21, outpatient 22, etc.).

• Negotiated Rate – The contracted amount the plan pays for the service.

• Rate Type – Specifies whether the rate is negotiated, flat fee, per unit, derived or percentage of billed charges.

• Expiration / Effective Dates – When the rate is valid.

In addition to these fields, Gigasheet enriches the data providing more context, for gaining market intelligence. Enrichments include NPI details, provider taxonomy codes, location information, EIN entity resolution, Smart Rate, and more. Gigasheet for Price Transparency also cleans machine-readable files of duplicates and zombie rates, and enriches MRF data to provide more context. Learn more about Gigasheet's price transparency solutions here: gigasheet.com/solutions 

For a complete list of fields available with Gigasheet for Price Transparency please contact sales@gigasheet.com