LIVE MONITORING: 52 PAYER MRF & STATE DOI PORTALS ACTIVE
RubricWard 50-STATE MRF
50-STATE PAYER MRF, MEDICARE MPFS RVU & NSA IDR ENGINE
52 PORTALS DE-NOISED 24/7 • ALL 50 U.S. STATE DOIS/APCDS + CMS FEDERAL IDR + MULTI-PAYER MRF

Stop Leaving Commercial Payer Revenue on the Table.

Legacy healthcare RCM consultants charge $25,000/yr or 15% of collections just to manually look up payer fee schedules. RubricWard unifies all 50 U.S. State DOI/APCD and CMS Transparency in Coverage (TiC) Machine-Readable Files, shreds payer Clinical Policy Bulletins (CPBs), models 25th/50th/75th-percentile CPT/DRG negotiated rates (% of Medicare, QPA Median, RVU/GPCI), and compiles an audit-ready 6-File OpenXML (.DOCX + .XLSX) Claim & IDR Package in 1 click.

TIER 2 // RUBRICWARD AUTOPILOT (52 PORTALS + 7 PAYER MRF & IDR APIS)

Pre-Modeled Commercial Payer MRF & NSA IDR Dossiers

  • • API #01: Payer Clinical Policy Bulletin (CPB), LCD/NCD & Prior-Auth Shredder
  • • API #02: Commercial Payer TiC MRF Allowed-Amount & QPA Benchmark Modeler
  • • API #03: CMS Medicare MPFS RVU, Geographic GPCI & ASC Facility Calculator
  • • API #04: 52-Portal Commercial Payer MRF, ERISA & NSA IDR Dispute Feed
  • • API #05: CMS NCCI PTP Edits, MUE Limits & Modifier 25/59/XU Bundling Auditor
  • • API #06: ERISA 29 CFR 2560.503-1 Medical Necessity & Level-II Appeal Generator
  • • API #11: Regional Specialty Group EIN/NPI Payer MRF Contract Spread Predictor
52 Portals
50-State DOI/APCD + CMS IDR + TiC MRF

Every State DOI/APCD commercial payer MRF index, CMS Federal NSA IDR cohort, and multi-payer CPT/DRG rate table normalized 24/7.

2.40M+ CPT/DRGs
TiC MRF & QPA Rate Vault

Verified 25th, 50th (Median QPA), and 75th percentile commercial payer negotiated rates by EIN/NPI and MSA.

6-File .ZIP
Native Word + Excel Formulas

Audit-ready OpenXML (.DOCX + .XLSX) MRF rate models, ERISA appeals, and NSA IDR briefs with live Excel formulas.

85% Faster
Zero $25K Consultant Lock-In

Shred payer CPBs, compute Medicare MPFS RVU/GPCI baselines, and draft ERISA/IDR briefs in seconds. Cancel anytime.

// ROLE-BASED PAYER CONTRACTING, RCM & NSA IDR WORKFLOW STEPPER

VP of Managed Care / Revenue Cycle Director Workflow

Eliminate 14+ hours of manual MRF parsing and appeal drafting per cohort. Benchmark commercial payer CPT/DRG allowed amounts (25th/50th/75th percentiles), peer EIN/NPI contract spreads, and HIPAA 835 ERA underpayment recovery ledgers.

Calculate Your Desk's Monthly Savings →
Stage 01 // 52-Portal Commercial Payer MRF & Federal NSA IDR Ingestion (API #04)

Normalizes commercial payer TiC MRF rate-disparity cohorts, CMS Federal NSA IDR arbitration benchmarks, and State DOI prompt-pay rules across all 50 U.S. States.

GET /v1/lettings/live -> 52 Portals Normalized
// INSTANT RCM & MANAGED CARE TEST DRIVE — ZERO CREDIT CARD REQUIRED

Get a Free 6-File OpenXML (.DOCX + .XLSX) Payer MRF & NSA IDR Package Sample

LIVE EXCEL FORMULAS INCLUDED
Includes Volume I–V (.DOCX + .XLSX) + 00_RubricWard_Appeal_and_IDR_Readiness_Manifest.json
// PAYER RATE & IDR MOAT — 52 ACTIVE PORTALS & 7 CORE REVENUE RECOVERY ENGINES

Why Legacy RCM Consulting & Raw MRF Files Fail Revenue Cycle Teams — And What RubricWard Automates

01 // PAYER CPB, LCD/NCD & TIMELY-FILING SHREDDING

Automatically extracts commercial payer Clinical Policy Bulletin (CPB) prior-authorization criteria, step-therapy gates, and timely-filing deadlines via API #01 & API #04.

02 // COMMERCIAL PAYER TIC MRF & QPA RATE MODELING

Benchmarks every CPT/HCPCS/DRG code against 25th, 50th (Median QPA), and 75th percentile commercial payer MRF negotiated rates and peer EIN/NPI spreads via API #02 & API #11.

03 // MEDICARE MPFS RVU/GPCI, NCCI & ERISA 29 CFR 2560 APPEALS

Computes county-specific Medicare MPFS RVU/GPCI baselines, audits CMS NCCI PTP & Modifier 25/59 bundling edits, and drafts statutory ERISA 29 CFR 2560.503-1 appeals via API #03, API #05 & API #06.

RCM & PAYER RATE CAPABILITY LEGACY RCM CONSULTANTS & RAW TERABYTE JSON MRF FILES RUBRICWARD AUTONOMOUS PAYER MRF & IDR ENGINE
Commercial Payer TiC MRF Rate BenchmarksUnparseable multi-terabyte payer JSON files; blind contract negotiationsAutomated 25th / Median QPA / 75th-Pct CPT & DRG benchmarking (API #02)
Payer CPB & CMS LCD/NCD Policy ShreddingManual reading of 150-page UHC/Aetna/BCBS Clinical Policy BulletinsInstant prior-auth checklist + timely-filing window extraction (API #01)
CMS Medicare MPFS RVU & GPCI BaselinesManual CMS RVU lookup & locality GPCI spreadsheet mathLocality-matched Work/PE/MP RVU + GPCI + ASC grouper rate (API #03)
CMS NCCI Edits & ERISA 29 CFR 2560.503-1 AppealsGeneric template letters; high CO-45 / CO-50 / CO-97 denial write-offsAutomated NCCI Modifier 25/59 audit & statutory ERISA appeal brief (API #05/#06)
RCM & IDR Deliverable FormatUnstructured PDF files1-Click 6-File OpenXML (.DOCX + .XLSX with live Excel formulas)
Pricing & Contract Terms$12,000–$18,000/yr mandatory annual seat lock-in$199–$499/mo self-serve, REST + MCP API included, cancel anytime
// INTERACTIVE PAYER CPB, MRF & NSA IDR SHREDDER

See How RubricWard Turns Raw Payer CPBs & Remittances Into Priced MRF & IDR Dossiers

TX DOI & NOVITAS // TXDOI-MRF-CPT-29881-DFW (ORTHOPEDIC & ASC SURGERY)
BEFORE // RAW PAYER CLINICAL POLICY BULLETIN & 835 ERA DENIAL TEXT
PAYER CLINICAL POLICY BULLETIN CPB-0592 & 835 ERA REMITTANCE (CARC CO-45 / CO-50)
Claim CPT 29881 (Knee Arthroscopy Meniscectomy) & CPT 27447 (Total Knee Arthroplasty) adjusted under CARC CO-45 to QPA $920.00. Payer asserts 6-week physical therapy prerequisite and NCCI Column 2 bundling on ipsilateral compartment.
AFTER // RUBRICWARD AI PAYER MRF, MEDICARE MPFS & ERISA/IDR OUTPUT
1. COMMERCIAL PAYER TIC MRF BENCHMARK (API #02):
   - CPT 29881 (420 Claims): MRF 25th $640.00 | Median QPA $1,485.00 | 75th-Pct Target $1,890.00 ($793,800.00)
   - CPT 27447 (115 Claims): MRF Median QPA $9,420.00 | 75th-Pct Target $11,850.00 ($1,362,750.00)
2. MEDICARE MPFS RVU/GPCI & NCCI AUDIT (API #03/#05):
   - DFW Locality 04412-11 MPFS Baseline Verified • Modifier 59/XS Distinct Compartment Supported
3. ERISA 29 CFR 2560.503-1 & PROMPT-PAY (API #06/#09):
   - TX Ins. Code § 1301.103 (18% APR Penalty) + NSA 45 CFR 149.510 IDR Brief Ready
// MOAT #1 — IN-MEMORY PURE-PYTHON OPENXML COMPILER

Inspect All 6 Files Inside Every RubricWard Claim & IDR Package (.ZIP)

Download Live 6-File .ZIP Now →
Volume_I_Payer_CPB_LCD_Prior_Auth_and_Medical_Necessity_Matrix.docx
Microsoft Word OpenXML (.DOCX)

Full Commercial Payer Clinical Policy Bulletin (CPB) & CMS LCD/NCD shred: Prior-Authorization Checklist, Step-Therapy Exceptions, NCCI Modifier 25/59 Rules, and Timely-Filing Windows.

PAYER CLINICAL POLICY BULLETIN (CPB) & CMS LCD/NCD SHRED
- Timely Filing & ERISA Appeal Window: 180 Calendar Days from EOB/835 ERA under 29 CFR 2560.503-1
- State Statutory Prompt-Pay Interest: 18% APR Penalty (TX Ins. Code § 1301.103)

REQUIRED CLINICAL & PRIOR-AUTH DOCUMENTATION (EXTRACTED):
- CPT 29881 / 27447: Weight-Bearing Radiograph / MRI Report + 6-Week Conservative Therapy Notes
- CMS NCCI PTP Override: Operative Note Documenting Distinct Compartment (Modifier 59 / XS)
- CPT 99214-25: Separately Identifiable E/M HPI & MDM Documentation
- Federal NSA IDR Window: 30-Business-Day Open Negotiation -> 4-Business-Day IDR Initiation
// REVENUE CYCLE & PAYER CONTRACTING ROI CALCULATOR

Calculate Your RCM & Payer Contracting Desk's Monthly Savings & Recovery

MONTHLY PAYER MRF COHORTS / IDR CASES AUDITED8 cohorts/mo
MANUAL MRF PARSING & APPEAL DRAFTING HOURS PER CASE14 hrs/cohort
LOADED SENIOR RCM / MANAGED CARE ANALYST COST ($/HR)$115/hr
RCM ANALYST HRS SAVED
95 hrs / mo
MONTHLY PAYROLL SAVED
$10,925 / mo
ANNUAL PAYROLL SAVED
$131,100 / yr
NET RETURN MULTIPLE
21.9x ROI vs. $499/mo Tier 2
// LIVE 52-PORTAL COMMERCIAL PAYER TIC MRF, ERISA & NSA IDR WIRE

Active Commercial Payer TiC MRF Rate Disparities & NSA IDR Cohorts

12 PREVIEW MRF COHORTS SHOWN
CASE / COHORT ID PAYER MRF COHORT & CPT/DRG SCOPE REGULATORY PORTAL / MSA COHORT MRF VALUE UNDERPAYMENT % FILING WINDOW ACTION
TXDOI-MRF-CPT-29881-DFW [TXDOI-MRF-CPT-29881-DFW] UHC & BCBS-TX Commercial MRF Rate Disparity, ASC Facility Fee & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic Surgery) Texas Department of Insurance (TDI) & CMS Novitas JH Payer MRF Index — Dallas-Fort Worth MSA $1,845,000 14.5% 2026-11-18
CADMHC-MRF-CPT-63030-SFO [CADMHC-MRF-CPT-63030-SFO] Anthem Blue Cross & Aetna MRF Rate Spread, Knox-Keene Prompt-Pay & ERISA Appeal (CPT 63030 / 22551 Spine & Neurosurgery) California Department of Managed Health Care (DMHC) & Noridian JE MRF Index — Bay Area MSA $2,480,000 18.0% 2026-11-20
FLOIR-MRF-CPT-45378-MIA [FLOIR-MRF-CPT-45378-MIA] Florida Blue & UnitedHealthcare GI Endoscopy / ASC MRF Rate Spread & FL Stat. § 627.6131 Prompt-Pay Audit (CPT 45378 / 43239) Florida Office of Insurance Regulation (OIR) & First Coast JN MRF Index — Miami-Dade MSA $1,560,000 12.65% 2026-11-24
VABOI-MRF-CPT-99285-RIC [VABOI-MRF-CPT-99285-RIC] Anthem HealthKeepers & Cigna Emergency Medicine / Radiology Out-of-Network NSA IDR & Downcoding Audit (CPT 99285 / 74177) Virginia Bureau of Insurance (SCC) & Palmetto GBA JM MRF Index — Northern VA / Richmond MSA $2,120,000 12.0% 2026-11-25
PAPID-MRF-CPT-66984-PHL [PAPID-MRF-CPT-66984-PHL] Highmark BCBS & Independence Blue Cross Ophthalmology / Cataract ASC MRF Rate Spread & Act 68 Prompt-Pay (CPT 66984 / 67028) Pennsylvania Insurance Department (PID) & Novitas JL MRF Index — Philadelphia MSA $1,420,000 11.0% 2026-11-26
NYDFS-MRF-CPT-01402-NYC [NYDFS-MRF-CPT-01402-NYC] Empire BCBS, EmblemHealth & Oxford Anesthesiology / Plastic Reconstructive NSA IDR & NY ISC § 3224-a Prompt-Pay (CPT 01402 / 19318) New York State Department of Financial Services (NYDFS) & NGS JK MRF Index — New York Metro MSA $3,150,000 16.5% 2026-11-27
ILDOI-MRF-CPT-93458-CHI [ILDOI-MRF-CPT-93458-CHI] BCBS-IL & UnitedHealthcare Cardiology / Outpatient Cath Lab MRF Rate Benchmark & 215 ILCS 5/368a Prompt-Pay (CPT 93458 / 92928) Illinois Department of Insurance (IDOI) & NGS J6 MRF Index — Chicago Metro MSA $1,940,000 13.0% 2026-11-28
GAOCI-MRF-CPT-47562-ATL [GAOCI-MRF-CPT-47562-ATL] Anthem BCBS-GA & Ambetter General Surgery / Bariatric ASC MRF Rate Spread & O.C.G.A. § 33-24-59.14 Prompt-Pay (CPT 47562 / 49650) Georgia Office of Commissioner of Insurance (OCI) & Palmetto GBA JJ MRF Index — Atlanta MSA $1,680,000 12.5% 2026-11-30
NCDOI-MRF-CPT-70553-CLT [NCDOI-MRF-CPT-70553-CLT] Blue Cross NC & Cigna Diagnostic Imaging / IDTF MRI MRF Rate Benchmark & N.C.G.S. § 58-3-225 Prompt-Pay (CPT 70553 / 72148) North Carolina Department of Insurance (NCDOI) & Palmetto GBA JM MRF Index — Charlotte / Raleigh MSA $1,390,000 11.5% 2026-12-01
OHODI-MRF-CPT-52356-CMH [OHODI-MRF-CPT-52356-CMH] Anthem BCBS-OH & Medical Mutual Urology / Lithotripsy ASC MRF Rate Spread & O.R.C. § 3901.389 Prompt-Pay (CPT 52356 / 50590) Ohio Department of Insurance (ODI) & CGS J15 MRF Index — Columbus / Cleveland MSA $1,490,000 11.0% 2026-12-02
CMS-NSA-IDR-2026-Q4-FED [CMS-NSA-IDR-2026-Q4-FED] Federal No Surprises Act (45 CFR 149.510) Certified IDR Entity Arbitration & ERISA 29 CFR 2560.503-1 Multi-Specialty Benchmark Centers for Medicare & Medicaid Services (CMS) CCIIO & EBSA Federal IDR Portal — National Docket $3,850,000 15.0% 2026-12-03
MUNICIPAL-ASC-RCM-2026-09 [MUNICIPAL-ASC-RCM-2026-09] Multi-State Ambulatory Surgery Center (ASC) Payer Contract Renegotiation, 835 Underpayment & GFE Compliance Audit Multi-State Self-Funded Municipal / Public Employee Health Plan & Commercial ASC Network Index $2,250,000 14.0% 2026-12-04
// 52 ACTIVE COMMERCIAL PAYER TIC MRF & STATE DOI PORTALS

50-State DOI/APCD, CMS Federal NSA IDR & Multi-Payer TiC MRF Coverage

PORTAL // USACE
LIVE
CMS Federal NSA IDR & TiC MRF
PORTAL // MUNI
LIVE
Multi-Payer Commercial TiC MRF
PORTAL // TX
LIVE
TX DOI & APCD MRF
PORTAL // CA
LIVE
CA DMHC & HCAI MRF
PORTAL // FL
LIVE
FL OIR & AHCA MRF
PORTAL // VA
LIVE
VA BOI & APCD MRF
PORTAL // PA
LIVE
PA PID & PHC4 MRF
PORTAL // NY
LIVE
NY DFS & SPARCS MRF
PORTAL // IL
LIVE
IL DOI & HFS MRF
PORTAL // GA
LIVE
GA OCI & APCD MRF
PORTAL // NC
LIVE
NC DOI & HIEA MRF
PORTAL // OH
LIVE
OH ODI & Medicaid MRF
PORTAL // WA
LIVE
WA OIC & WA-APCD MRF
PORTAL // MI
LIVE
MI DIFS & MRF Index
PORTAL // NJ
LIVE
NJ DOBI & OON IDR
PORTAL // MA
LIVE
MA DOI & CHIA APCD
PORTAL // CO
LIVE
CO DORA & CIVHC APCD
PORTAL // AZ
LIVE
AZ DIFI & AHCCCS MRF
PORTAL // MN
LIVE
MN Commerce & APCD
PORTAL // TN
LIVE
TN TDCI & All-Payer MRF
PORTAL // IN
LIVE
IN IDOI & APCD MRF
PORTAL // MO
LIVE
MO DCI & Payer MRF
PORTAL // WI
LIVE
WI OCI & WHA PricePoint
PORTAL // SC
LIVE
SC DOI & RFA Health MRF
PORTAL // OR
LIVE
OR DCBS & APAC MRF
PORTAL // CT
LIVE
CT CID & OHS APCD
PORTAL // UT
LIVE
UT UID & OHCS APCD
PORTAL // NV
LIVE
NV DOI & Patient Protection
PORTAL // AL
LIVE
AL DOI & Commercial MRF
PORTAL // LA
LIVE
LA LDI & Health MRF
PORTAL // KY
LIVE
KY DOI & KHIE MRF
PORTAL // OK
LIVE
OK OID & All-Payer MRF
PORTAL // IA
LIVE
IA IID & Hospital MRF
PORTAL // KS
LIVE
KS KID & Payer MRF
PORTAL // AR
LIVE
AR AID & APCD MRF
PORTAL // MS
LIVE
MS MID & Commercial MRF
PORTAL // NM
LIVE
NM OSI & APCD MRF
PORTAL // NE
LIVE
NE DOI & Payer MRF
PORTAL // ID
LIVE
ID DOI & Commercial MRF
PORTAL // HI
LIVE
HI DCCA & Health MRF
PORTAL // NH
LIVE
NH ID & CHIS APCD
PORTAL // ME
LIVE
ME BOI & MHDO APCD
PORTAL // RI
LIVE
RI OHIC & APCD MRF
PORTAL // MT
LIVE
MT CSI & Payer MRF
PORTAL // DE
LIVE
DE DOI & DHIN APCD
PORTAL // SD
LIVE
SD DLR & Payer MRF
PORTAL // ND
LIVE
ND ID & Commercial MRF
PORTAL // AK
LIVE
AK DOI & 80th-Pct Usual Rate
PORTAL // VT
LIVE
VT DFR & VHCURES APCD
PORTAL // WV
LIVE
WV OIC & Health MRF
PORTAL // WY
LIVE
WY DOI & Multi-Payer MRF
PORTAL // MD
LIVE
MD MIA & HSCRC All-Payer