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Batching: Grouping Similar Cases
for Efficiency 

Learn how grouping qualified disputes can streamline the IDR process while maintaining fairness and compliance with federal guidelines.

What
is batching?

Batching refers to the process of grouping multiple similar cases together for review. This method is commonly used when:

  • Multiple disputes involve the same healthcare provider or facility,
  • Claims share common characteristics, such as denial reasons or medical procedures, and
  • A streamlined decision-making process is beneficial for efficiency.

Requirements for Line Items and Services
to be Batched Together

All of the requirements below must be met for items to be properly batched.

  • Batching is limited to Qualified Independent Dispute Resolution items and services that were from the same provider, group of providers, facilities, or provider of air ambulance services under the same National Provider Identifier (NPI) or tax identification number (TIN).
  • Payment for the items and services must come from the same group health plan or insurance.
  • The items that are included in the batch need to have occurred during a 30-day business period following the date on which the earliest included item or service occurred (or had a 30-business-day open negotiation period that ended during the same 90-calendar-day cooling-off period).
  • The qualified IDR items or services must be related to the treatment of a similar condition. Guides for items or services that are related to the treatment of a similar condition are in the tables below. To be batched, the CPT codes need to be in the same grouping, as specified in the tables below. For example, items and services for the following CPT codes could be batched because they fall under the same Diagnostic Radiology (Imaging) Grouping: 70010-71555, 72020-72295, 73000-73725, 74018-74363, 74400-74775, 75557-75989, 76000-76499, R0070-R0076.

Furthermore, air ambulance services for a single air ambulance transport, including an air ambulance mileage code and base rate code, may be submitted as a batched dispute

CMS has proposed that each batch submitted may contain up to 25 line items.

By handling multiple cases at once, batching allows for quicker resolutions and reduces administrative burden. However, individual nuances within each case are still considered to ensure fairness.

Batching Resources

Proposed Radiology CPT Code Spans for Permissible Batched Determinations Level I HCPCS Codes (CPT)

Learn More

Proposed Pathology and Laboratory CPT Code Spans for Permissible Batched Determinations

Learn More

Commence as a IDR Entity

The Department of Health and Human Services, the Department of Labor, and the Department of the Treasury have certified Livanta LLC DBA Commence to serve as a certified independent dispute resolution (IDR) entity in the Federal IDR process between out-of-network providers, facilities, or providers of air ambulance services and group health plans, health insurance issuers in the group and individual market, or Federal Employees Health Benefits (FEHB) Carriers. If an out-of-network provider, facility, or provider of air ambulance services and a health plan, issuer, or FEHB Carrier cannot agree on the payment amount for an out-of-network item or service provided on or after January 1, 2022 that is covered by the No Surprises Act, as a certified IDR entity, we can be selected to determine the payment amount.

IDR Guidance

See IDR Guidance Page 33 Section 10.2

Contact CMS

Contact CMS About the IDR Process

Any inquiries related specifically to the Federal IDR process, or to initiate a dispute, should be directed to the official CMS IDR email: federalidrquestions@cms.hhs.gov.