Terms of Use

What the Site provides

The Site is an estimation and reference tool, provided for informational, planning, and educational purposes. Most of it is free to use and requires no account.

No professional advice; not official adjudication

Output from the Site is an estimate. It is not a payment determination, a guarantee of reimbursement, legal or billing advice, or medical advice, and it is not a substitute for official adjudication by a payer or its contractors. Coding and billing decisions remain the responsibility of the submitting provider.

Accuracy

We work from published rate data and aim to keep the Site current and correct, but rates and factors change and errors are possible. The Site is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, merchantability, or fitness for a particular purpose. Verify any figure that matters against the official source before relying on it.

Acceptable use

• Do not attempt to gain unauthorized access to the Site, its API, or its underlying systems or data.
• Do not scrape, bulk-download, or systematically extract the datasets, or circumvent rate limits, access controls, or pagination.
• Do not use the Site in a way that degrades or disrupts it for others.
• Do not misrepresent output from the Site as an official determination.
• Do not copy, reverse engineer, decompile, or reproduce the Site’s pricing logic, grouping logic, edits, or software, or attempt to derive them from the Site’s output.
• Do not use the Site, its API, or its output to build, populate, train, or benchmark a competing product, dataset, or model, or resell or redistribute its output, without our written permission.
• Do not access the Site or its API by automated means except with an API key we issued, within that key’s limits.
• Do not share sign-in sessions or API keys, or remove copyright or ownership notices.

Claim files and health information

The Site does not need protected health information (PHI) to price a claim, and we ask that you use de-identified or test claims where you can. Claim and remittance files such as 837s and 835s can contain PHI. The claim import page removes the patient identifiers these formats carry in their usual places before a text file leaves your browser, and our server removes them again before reading it; a UB-04 PDF cannot be cleaned that way and is sent as is. That removal is a safeguard, not a guarantee: it is automatic, it can miss an identifier entered somewhere unexpected, and it does not make the Site HIPAA-compliant or make an upload of PHI appropriate. If you upload or paste a file containing PHI, you are responsible for that PHI: for having the right to use it this way under your own obligations (including HIPAA and your agreements with payers and patients), and for sending no more than you need. What the Site removes, reads, discards, and never keeps or logs is set out in our Privacy Policy.

PayerParity does not create, receive, maintain, or transmit PHI on your behalf as a business associate, and using the Site creates no business associate relationship and no business associate agreement. If your obligations require one for a given use, do not upload PHI to the Site.

Exports are estimates, not claims

Files the Site produces, including repriced 837I and 837P files, 835 remittance files, worksheets, PDFs, spreadsheets, and CSVs, are estimates for review, testing, and analysis. Do not submit them to any payer, clearinghouse, or government program as a claim, a remittance, or a payment determination, and do not represent them as one.

Provider screening. Where the Site compares a claim's providers with public lists (today the OIG List of Excluded Individuals/Entities, as of the file date it shows), a result is a prompt to check, not a finding: a match must be confirmed in OIG's online search with the person's SSN or the entity's EIN, and "no match" covers only the list named. It is not a payment determination or legal advice and does not replace your own exclusion screening; the inputs are not stored or logged. Arranging or contracting with an excluded person can bring civil money penalties (42 CFR 1003.200(b)(4)). OIG recommends screening monthly.

Intellectual property

Underlying public rate data are government works and are not claimed by us. The Site’s software, interface, written guides, and the organization and presentation of the data are the property of PayerParity. © 2026 PayerParity. All rights reserved. The Site and its output contain identifying markers so that copied material can be recognized. Report suspected copying, or ask about licensing, at info@payerparity.com.

CPT notice

CPT® is a registered trademark of the American Medical Association. CPT codes and descriptions only are copyright 2025 American Medical Association. All rights reserved. Applicable FARS/DFARS restrictions apply to government use. Fee schedules, relative value units, conversion factors and related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services, and assumes no liability for data contained or not contained herein. CPT codes appear on the Site for reference in pricing; no license to CPT is granted by these terms.

Limitation of liability

To the fullest extent permitted by law, PayerParity is not liable for any indirect, incidental, consequential, or special damages, or for lost revenue, denied or underpaid claims, or business losses, arising from use of or reliance on the Site.

Indemnity

You agree to defend, indemnify, and hold harmless PayerParity and its owners, employees, and contractors from any claims, losses, liabilities, damages, and expenses (including reasonable attorneys’ fees) arising from your misuse of the Site, your breach of these terms, any PHI or other data you upload or paste, or your submission of the Site’s output to any payer, clearinghouse, or government program.

Changes

We may update these terms; the date above reflects the current version. Continued use after a change constitutes acceptance.

Contact

info@payerparity.com