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Transparency in Coverage

Beginning in July 2022, health plans and third-party administrators (TPAs) have been required to comply with the federal Transparency in Coverage final rule issued by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury. This rule requires the public disclosure of certain healthcare pricing information through machine‑readable files, in accordance with CMS technical standards.

While compliance with the Transparency in Coverage rule is the responsibility of the applicable health plan or issuer, Prime Health Services supports our payer and administrator partners by providing the in‑network provider data portion of these disclosures.

Schema Version Update (v2.0)

Prime Health Services now publishes Transparency in Coverage machine‑readable files using CMS Transparency in Coverage Schema Version 2.0, the current technical standard required for files published on or after February 2, 2026

Prime Health Services In-Network file

JSON (500 KB gz compressed)

These files are updated periodically to reflect the most current available information.