Federal IDR operations final rule published: what it changes
The Departments of the Treasury, Labor and Health and Human Services, with the Office of Personnel Management, published the Federal Independent Dispute Resolution Operations final rule on June 4, 2026. It cuts the federal IDR administrative fee from $115 to $15 per party, limits a batched dispute to 50 line items and requires payers to register in a federal registry.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · 
In short: the final rule appeared at 91 FR 33900 on June 4, 2026 and took effect on August 3, 2026. It changes fees, batching, payer disclosures, remittance codes and the notice steps for federal IDR, and each part has its own start date.
What did the Departments publish on June 4, 2026?
The document is titled Federal Independent Dispute Resolution Operations, CMS-9897-F, RIN 0938-AV15, Federal Register document 2026-11140, 91 FR 33900. Treasury (TD 10049), Labor and HHS issued it jointly with the Office of Personnel Management to amend the IDR rules under the No Surprises Act.
CMS's No Surprises notices page says the final rules were released on May 28, 2026. Federal Register publication followed on June 4, 2026, and the rule's effective date is August 3, 2026. Our post on the August 3 effective date separates that date from the start dates.
What does the final rule change for billing teams?
These are the changes a billing team feels first.
| Subject | What the rule says | Applies |
|---|---|---|
| Administrative fee | Sets the fee at $15 per party per dispute, down from $115. The Departments divided $119.4 million of estimated yearly cost by 6.9 million fees and rounded $17.41 down | Disputes initiated on or after June 11, 2026 |
| Batched disputes | Limits a batched dispute to 50 line items | Open negotiation periods beginning on or after November 1, 2026 |
| Payer disclosures | Adds the plan or issuer's legal business name and, when registered, its registry number to the information sent with an initial payment or denial | August 3, 2026 |
| Remittance advice | Requires payers to use specified CARCs and RARCs on paper and electronic remittance advice to flag whether the surprise billing rules apply | Items and services furnished on or after January 1, 2027 |
| Payer registry | Self-insured group health plans, FEHB carriers and issuers register in the federal IDR registry | 90 business days after the Departments announce registry functionality |
| Notices and entity selection | Moves open negotiation, initiation and entity selection to standard forms and new timing | Open negotiation periods beginning 90 calendar days after each announcement |
The rule also defines a bundled payment arrangement and rewrites the withdrawal and extension rules. The full list is on the IDR operations rule page.
Who does the rule affect?
Anyone who uses federal IDR for out-of-network claims is affected: hospitals, emergency departments and freestanding ERs, physician groups, other facilities, providers of air ambulance services, and the plans and issuers on the other side of each dispute.
Billing and appeals staff feel the fee drop and the batch limit. Payment posting staff will see new remark codes from January 1, 2027. The fee depends on the initiation date.
What should a billing team do now?
- Note the initiation date on every open dispute. CMS says the $15 fee applies to disputes initiated on or after June 11, 2026, and disputes initiated from January 22, 2024 through June 10, 2026 stay at $115 per party.
- Sort planned batches by the date open negotiation begins. A batch whose negotiation starts on or after November 1, 2026 must stay at 50 line items or fewer.
- Subscribe to the CMS notices page, where the Departments post each applicability announcement.
- Keep using the process in force today. Section 149.510(h)(10) says parties continue to follow the earlier text of the section until each applicability date.
What is still open?
Several parts wait for the Departments to announce that portal functionality is available. The preamble anticipates all functionality within 24 months of the effective date, and CMS's timeline guide expects Gateway functions in Spring 2027.
A correcting amendment followed on August 28, 2026, described in the correction notice post. The NSA deadline calculator handles the business day math.
How we handle it
We manage out-of-network reimbursement end to end, from open negotiation to outcome tracking. See out-of-network billing and IDR or book a call.
- Federal Independent Dispute Resolution Operations, final rule, 91 FR 33900 (June 4, 2026) · Federal Register (govinfo)
- CMS No Surprises Act notices · CMS
- Federal IDR Operations Final Rules Implementation Timeline Guide (August 7, 2026) · CMS
We check every rule, code and deadline against the official source. See our editorial policy.
Common questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01When was the federal IDR operations final rule published?
The Federal Register published it on June 4, 2026, as document 2026-11140 at 91 FR 33900. CMS's notices page says the Departments released the final rules on May 28, 2026. The rule's effective date is August 3, 2026, which is 60 days after publication.
02What is the federal IDR administrative fee under the new rule?
The administrative fee is $15 per party per dispute for disputes initiated on or after June 11, 2026. CMS's June 3, 2026 notice states that disputes initiated on or after January 22, 2024 but before June 11, 2026 remain at $115 per party per dispute.
03Does the final rule limit how many claims go in one IDR batch?
Yes. The final rule limits a batched dispute to 50 line items. CMS's August 3, 2026 notice says the limit applies to batched disputes with an open negotiation start date on or after November 1, 2026. Earlier batches stay under the earlier batching rules.
Talk to a billing lead.
A 20-minute call about your payers, volume and setup. Monday to Friday, 9am to 5pm Eastern.