What we check / Schema conformance

blockerHPT-L1-005

Methodology is present whenever a negotiated rate is present

Any row with a negotiated_dollar, negotiated_percentage, or negotiated_algorithm value must also state the methodology used to derive it (case rate, fee schedule, percent of total billed charges, etc.).

Regulatory citation

CMS v3.0.0 CSV/JSON data dictionary, standard_charges.methodology (required when negotiated fields present)

How to fix it

Populate standard_charge|methodology for every row that has a negotiated dollar, percentage, or algorithm value.

Active since

2024-01-01