IDR fees: who pays what, and when
The two fees in every federal IDR dispute — the administrative fee and the certified entity fee — and how payment and refunds work with medlitix.
Every federal IDR dispute involves two distinct fees that parties routinely conflate: a federal administrative fee, set and collected under the Departments' rules, and the certified IDR entity fee, set by the entity the parties select. They have different amounts, different payment mechanics, and different refund treatment. Here is how each works when medlitix is your certified IDR entity.
The administrative fee
Each party to a dispute pays a non-refundable administrative fee established by the Departments. It applies regardless of outcome and is not refunded to the prevailing party. The amount is set through rulemaking and has changed more than once — always confirm the current figure and payment instructions at cms.gov/nosurprises. This fee is a condition of the process itself; medlitix does not set it.
The certified IDR entity fee
The entity fee is medlitix's published charge for making the payment determination, fixed within ranges the Departments approve annually. Our current schedule, effective for disputes initiated on or after July 6, 2026:
| Single determination | $560 |
| Batched determination (up to 25 line items) | $795 |
| Each additional increment of 25 line items | +$135 |
Both parties pay the entity fee during the dispute, and after the determination the prevailing party's fee is refunded in accordance with federal IDR rules — economically, the non-prevailing party bears the entity fee. Batched pricing is transparent by design: the tiering lets you price a batch before you file it (see batching vs. bundling for the criteria a batch must meet).
How payment to medlitix works
When medlitix is selected, both parties receive an invoice with payment instructions at selection. Payment may be made by ACH or card, and timely payment is required for the dispute to proceed — determinations are not issued on unpaid disputes. Refunds to the prevailing party are issued to the payment method on file within 30 business days of the written determination. For invoice or payment questions, contact idrpayments@medlitix.org.
Budgeting a dispute end to end
For a single determination, a party's worst case is the administrative fee (non-refundable) plus $560 (refunded if you prevail). For batches, add the tier increments. Because the certified IDR entity fee varies by entity and is published in advance, it is one of the few costs in the process you can shop before selection — medlitix's full schedule is on the Federal IDR page, and the process timeline that drives when fees come due is covered in how to file a federal IDR dispute.
Invoice or payment questions?
Our payments team handles invoices, refunds, and payment methods; the IDR team handles everything else about your dispute.
Email idrpayments@medlitix.orgThis guide is general information, not legal advice. Fee amounts shown are medlitix's fees on file with the Departments for the stated effective date; the administrative fee is set by the Departments and published at cms.gov/nosurprises.