The federal IDR portal is where every No Surprises Act payment dispute is initiated, paid for, argued, and decided. Here's how the process runs inside it, what it costs in 2026, what changed under the May 2026 Operations Final Rule, and where filings fail.
The federal IDR portal is run by CMS on behalf of HHS, Labor, and Treasury at nsa-idr.cms.gov. Both the initiating party (usually the provider) and the non-initiating party (the plan) use it to submit the notice of IDR initiation, respond, select or object to the certified IDR entity, pay fees, upload offers and supporting information, and receive the determination.
You cannot initiate in the portal until the 30-business-day open negotiation period has run. See our open negotiation notice guide.
Within 4 business days after open negotiation ends. You identify the item/service, the plan (payer registration numbers are being phased in under the 2026 rule), the QPA and initial payment, and attest to eligibility. Batching similar items with the same payer happens here.
You propose an IDR entity; the plan can object within 3 business days. If no agreement, the Departments assign one. Fee ranges by entity are published on the CMS site.
Both parties pay the administrative fee; the certified IDR entity fee is paid by both and refunded to the prevailing party. See 2026 IDR fees.
The IDR entity (or the Departments) confirms the dispute qualifies: correct service type, plan type, no applicable state process, cooling-off period observed. This is where the largest share of disputes are thrown out.
One payment offer per party, with the information you want the arbiter to consider: training/experience, case complexity, market share, prior contracted rates, good-faith negotiation.
The arbiter picks one of the two offers. About 62% of H2 2025 determinations were issued within 30 business days.
The plan must pay within 30 calendar days of the determination. Late payment is common; enforcement runs through CMS complaints.
Enter the date of the payer's initial payment or denial. Business days exclude weekends and federal holidays.
Guidance only — the statutory clocks are counted in business days and can be affected by the date a payer receives a clean claim, weekends, and holidays. We verify every deadline claim by claim before filing.
Send us a sample of recent OON remits. We'll tell you which claims are IDR-eligible, what similar disputes have paid, and what we'd file. No fee unless we win you more.
Request a free eligibility review