External Independent Third-Party Review (EITPR) Cost Sheet
This document lists case rates, additional costs, total case rates, and administrative fees for External Independent Third-Party Reviews (medical necessity and adverse payment reviews) across calendar years 2020–2025; it informs billing/reimbursement and vendor payment calculations for EITPR services.
No material clinical or coverage changes in this revision.
EITPR Payment Schedule & Rules
EITPR payment schedule
Payment and fee schedule items included in the cost sheet:
ALL of the following
- CY 2020 = $435.00
- CY 2021 = $442.00
- CY 2022 = $448.00
- CY 2023 = $455.00
- CY 2024 OPTIONAL = $462.00
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.