What is a hospital MRF file?
A plain-language explainer on hospital machine-readable files, what they contain, and why they matter for contract negotiations.
Federal hospital price transparency rules require hospitals to publish machine-readable files (MRFs) showing the rates they have negotiated with payers. These aren't summary reports or estimates — they're structured data files, typically in JSON or CSV format, listing contracted rates by payer, plan, and billing code.
What MRFs actually contain
An MRF file generally includes:
- Payer and plan identifiers — which insurance company and which plan product
- Billing codes — often MS-DRG for inpatient stays, APC or HCPCS for outpatient
- Negotiated rates — the dollar amount or percentage the hospital and payer agreed to
- Pricing methodology indicators — though these are not always clearly labeled
The data comes directly from the hospital's contract management systems. It's what the hospital actually bills and expects to be paid under each payer agreement.
Why MRFs matter beyond compliance
Most hospitals treat MRF publication as a regulatory checkbox. But the same files that satisfy CMS reporting requirements contain the rates your contracting team needs to benchmark against — especially when combined with payer transparency files (TiC), which show what the payer pays other hospitals.
The gap between your MRF and a comparable facility's rate under the same payer is negotiation leverage. The challenge is that raw MRF data is difficult to work with: large files, inconsistent formatting, and rates that appear to be fee-for-service when the underlying methodology may be DRG, case rate, or something else entirely.
MRFs vs. payer TiC files
Hospital MRFs show rates from the hospital's perspective — what they charge and expect to receive. Payer Transparency in Coverage (TiC) files show rates from the payer's perspective — what they pay across their entire provider network.
For negotiation leverage, payer TiC files are often more useful because they let you see what the same payer pays other facilities for the same code, not just what your hospital has agreed to accept.
The bottom line
An MRF file is not just a compliance artifact. It's a window into your own contracted rates — and when paired with payer disclosure data, it becomes the starting point for finding gaps that modeled benchmarks miss.
If you want to see what your payer already pays comparable facilities for the same services, request a free Parity Report.