Fees

The $15 admin fee changes which claims are worth disputing

The federal IDR administrative fee fell from $115 to $15 per party in June 2026. What that does to the math on small claims, and what it does not change.

4 min readRevise Medical

For disputes initiated on or after June 11, 2026, each party pays a $15 administrative fee per federal IDR dispute. For disputes initiated from January 22, 2024 until then, the fee was $115.2

What it changes

The admin fee is non-refundable. At $115 per party, a claim with $200 at stake lost more than half its value to the fee before anyone looked at it. At $15, the same claim keeps most of its value. For emergency medicine and radiology, where most claims are modest, that moves thousands of claims a year from "not worth it" to "worth filing".

What it does not change

  • The certified IDR entity fee. It is set by each entity and is much larger than the admin fee. It is refunded to the party that prevails, so a weak dispute still costs real money.
  • The clocks. Thirty business days to start open negotiation, thirty to negotiate, four to initiate. A cheap dispute filed late is still ineligible.
  • Eligibility. An ineligible filing costs the admin fee and time, and it erodes your standing with IDR entities.

How we use it

The engine scores every claim on expected cash after fees: the likely award given the payer, the IDRE and the QPA, times the chance of payment, minus the fees at risk. A lower admin fee shifts the threshold down. Our own cost per dispute is the other half of the math, which is why we built for about $15 per dispute rather than a case manager’s hour.10

Summaries of public rules and filings. Not legal advice.

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Sources

  1. 2CMS, No Surprises Act notices: the federal IDR administrative fee is $15 per party per dispute for disputes initiated on or after June 11, 2026 ($115 before). Source
  2. 3Federal Independent Dispute Resolution Operations, final rules, Federal Register doc. 2026-11140, June 4, 2026: batched disputes limited to 50 line items; most process changes apply to open negotiations that begin 90 days after the Departments announce the supporting functionality. Source
  3. 10Revise estimate from our engine design (docs/07): about $15 fully loaded per dispute against an estimated $150 for a case-manager model. Illustrative until we publish measured costs.