Federal IDR guides
What does federal IDR cost, and who pays?
Two fees: $15 to CMS and an IDR entity fee of a few hundred dollars. Who pays each, what comes back if you win or settle, and what June 2026 changed.
Verified September 11, 2026
Short answer
Both sides pay two fees up front. A $15 fee to CMS, and an IDR entity fee of a few hundred dollars. The CMS fee never comes back. The entity fee comes back in full if you win, half if you settle, and in full if the case is thrown out. Lose and the entity keeps it.
In the 2025 files, the median compensation recorded for an IDR entity was $498 on a single dispute and $750 on a batch, counting only disputes where a positive amount was recorded.
CMS fee
$15
Per side, per dispute, never refunded
Entity fee, single
$498
Median recorded, 2025
Entity fee, batch
$750
Median recorded, 2025
Back if you win
All of it
Entity fee, within 30 business days
The two fees
| Fee | Amount | Paid by | Refunded? |
|---|---|---|---|
| CMS fee | $15 per side per dispute | Both sides | Never |
| IDR entity fee | Set by the entity. Base fees run $200 to $840 for one claim and $268 to $1,173 for a batch, plus more for bigger batches | Both sides, held until the case ends | Depends on how it ends |
Both are due with your offer, within 10 business days of the entity being picked.
What comes back
| How the case ends | Entity fee | CMS fee |
|---|---|---|
| Decision, you win | Refunded in full within 30 business days | Kept by CMS |
| Decision, you lose | Kept by the IDR entity | Kept by CMS |
| Settled or withdrawn | Usually half to each side. Depends on when it settles and what the parties agree | Kept by CMS |
| Ruled ineligible | Refunded in full to both sides | Kept by CMS |
In a batch, whoever wins fewer lines is the loser. A tie splits the fee.
The batch base fee covers a set number of lines. Past that, entities add more for each extra block of lines, so a 50-line batch can cost several hundred dollars above the base ceiling. Take the number from the entity you actually get, not from the range.
What losing actually costs
The entity fee plus the $15. Say you file 100 single claims at about $498 each and lose 14 of them, the 2025 national rate. You are out about $7,000 in entity fees and $1,500 in CMS fees.
What is changing
The June 2026 fee cut
The CMS fee was $115 per side from January 2024 to June 10, 2026. It dropped to $15 for disputes filed on or after June 11, 2026.
That changes what is worth filing. At $115 plus a $500 entity fee, a claim had to be worth a few hundred dollars more than the payer's offer to make sense. At $15, small claims that were not worth it now are.
What matters is the date you file, not the date of service.
What the fee is not
The CMS fee is not in the public data. Any figure you see for it on a report is an estimate. What the files do record is the compensation for each dispute, which is not the same thing as the fee an entity quotes you up front.
Fees are not damages. Nothing in the process makes one side pay the other's fees, beyond the refund rules above.
Sources
CMS notice, "IDR Administrative Fee Update," June 3, 2026; Federal IDR Operations Final Rule, May 2026; CMS certified IDR entity fee ranges (2024 rule); CMS Federal IDR Guidance for Disputing Parties, section 10; CMS Federal IDR Public Use Files, 2025 (median IDR entity compensation by dispute type).
Every number on this page comes from public CMS files or the federal rule. Our methodology explains how we count. Questions? sales@recoursehealth.com
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