CMS Price Transparency Is Changing — But the Need for Analytics Is Not
- Maria Nikol, MJ
- Dec 23, 2025
- 2 min read
Recent CMS proposals to update price transparency requirements have generated a familiar question:
If the government is making health care prices easier to disclose, will tools for price transparency still be necessary?
The short answer is yes — arguably more than ever.
The proposed changes are meaningful and welcome. But they do not make health care pricing simple, self‑explanatory, or easily consumable by the average employer, provider, or patient. What they do instead is shift where value is created — away from basic data access and toward interpretation, accuracy, and insight.
What CMS Is Actually Changing
CMS’s proposed updates focus on improving how price transparency data is structured and maintained, not on turning it into a consumer‑friendly price list.
Key themes include:
Reorganizing machine‑readable files to reduce redundancy and improve consistency
Adding change logs so stakeholders can see what has changed between data releases
Reducing reporting burden by moving from monthly to quarterly updates
Providing additional context, such as utilization indicators[1]
These changes are designed to make the data easier for systems and analysts to process — not easier for humans to interpret on their own.
That distinction matters.
“Machine‑Readable” Still Doesn’t Mean “Understandable”
Even in an improved format, price transparency data will continue to include:
Millions (or billions) of rows
CPT and HCPCS codes
Network identifiers
TIN and NPI mappings
Site‑of‑care and billing‑class distinctions
Contract‑specific nuances and edge cases
This is not information someone can open in a spreadsheet and casually explore.
CMS is making the raw ingredients better organized — but raw ingredients still need a recipe, a kitchen, and expertise.
Access Was Never the Hardest Problem — Trust Is
Price transparency challenges today are rarely about whether data exists. They are about whether the data can be found and trusted.
Common issues include:
Rates that can’t be found for known contracts
Prices that don’t reconcile to real reimbursement
Incorrect or incomplete TIN/NPI attribution
Misinterpretation of units, modifiers, or billing classes
Large discrepancies across vendors using the same source data
CMS rules do not resolve these problems.
They cannot tell you whether a rate is accurate, applicable, competitive, or actionable. That work still requires validation, reconciliation, and experience.
The Bottom Line
CMS is making price transparency data easier to process — not easier to understand.
As the data improves, organizations will need trusted analytics partners to turn disclosure into decisions.
Transparency is not the end of the journey.
It’s the beginning.
How Revelar Analytics Can Help
As price transparency data becomes more standardized and more widely available, the real differentiator is no longer access — it’s accuracy, interpretation, and actionability.
Revelar Analytics helps employers, providers, and advisors:
Validate and trust transparency data
Understand which rates actually matter
Identify competitive gaps and opportunities
Track changes over time with confidence
Turn disclosure into informed decisions
If you’re navigating the next phase of price transparency and want clarity — not just more data — Revelar Analytics can help.
👉 Learn how Revelar turns transparency data into insight.
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