Health Plan Transparency in Coverage Machine Readable Files

The Health Plan Transparency Rule was designed to help consumers better understand the cost associated with their health care.  The first phase effective July 1, 2022, requires employers with group health plans to begin posting pricing information for covered items and services in a Machine Readable File format to be used by third party researchers and app developers. Additional requirements will go into effect in 2023 and 2024 and will provide availability to member friendly tools to access this pricing information and enhance consumers’ ability to shop for the health care that best meet their needs.

Third party researchers and app developers may access the Blue Cross Blue Shield of Texas Machine Readable Files for the Encompass Health Self-Funded Medical Plans using this BCBS TX Machine Readable Files link and they can access the files for SurgeryPlus via SurgeryPlus Provider pricing transparency link.