Detailed descriptions of field names from Payer Price Transparency Machine-Readable files.
For pricing information, please see https://payerset.com/pricing
There is an additional PLAN_MAP table that contains details about the Plans and Plan Types.
Last updated
| Field Name | Description / Sample Values | Original Source |
|---|---|---|
ADDITIONAL_INFORMATION
Additional information relevant to rate
PAYER MRF
BILLING_CLASS
Institutional or Professional
PAYER MRF
BILLING_CODE
Billing code as-is in MRF
PAYER MRF
BILLING_CODE_MODIFIER
Modifiers for different rates (22-99, P1)
PAYER MRF
BILLING_CODE_NAME
Billing code name as-is in MRF
PAYER MRF
BILLING_CODE_TYPE
HCPCS, CPT, MS-DRG, etc
PAYER MRF
BILLING_CODE_TYPE_VERSION
Version of the billing code (2023, 2024)
PAYER MRF
EXPIRATION_DATE
Expiration date of the rate (12/31/2024)
PAYER MRF
NEGOTIATED_RATE
Negotiated Rate value
PAYER MRF
NEGOTIATED_TYPE
Fee schedule, negotiated, percentage, per diem
PAYER MRF
NEGOTIATION_ARRANGEMENT
Fee for service (ffs) or Bundle
PAYER MRF
NPI
Provider ID
PAYER MRF
SERVICE_CODES
Location of service (11, 21, 22, etc)
PAYER MRF
TIN_TYPE
EIN or NPI
PAYER MRF
TIN_VALUE
Value of associated EIN or NPI
PAYER MRF
NPPES_CITY
City Name from NPPES
NPPES
NPPES_STATE
State Name from NPPES
NPPES
NPPES_ORGANIZATION_NAME
Organization Name from NPPES
NPPES
NPPES_ORGFRIENDLYNAME
Org Name + DBA Name if present
ADDED BY PAYERSET
NPPES_PRIMARY_TAXONOMY_CODE
Primary taxonomy derived using switches in NPPES file
ADDED BY PAYERSET
NUCC_TAXONOMY_GROUPING
High-level taxonomy grouping (Allopathic, Hospitals, Hospital Units, etc)
NUCC
NUCC_TAXONOMY_CLASSIFICATION
More granular taxonomy classification (Clinic/Center, Abmulance, Nursing Care, etc)
NUCC
NUCC_TAXONOMY_SPECIALIZATION
Most granular taxonomy (Adult Mental Health, Oncology, Orthopedic Surgery, etc...)
NUCC
PAYER
Payer column added for convenience
ADDED BY PAYERSET
PAYERSET_BILLING_CODE_NAME
Payerset standardized name of 21k+ billing codes
ADDED BY PAYERSET
PAYERSET_BILLING_CODE_CATEGORY
Payerset categorization of 21k+ billing codes
ADDED BY PAYERSET
PAYERSET_BILLING_CODE_SUBCATEGORY
Payerset subcategorization of 21k+ billing codes
ADDED BY PAYERSET
PAYERSET_BILLING_CODE_TYPE
Payerset categorization of billing code types
ADDED BY PAYERSET
PLAN_ID
Payerset-created Plan ID that links back to original plan via PLAN_MAP table
ADDED BY PAYERSET