Workspace pricing
Pricing for payer-specific revenue cycle workspaces
Workspace modules are paid, source-linked products organized by payer. Developers can try the API free in the playground — no account required.
Medicare Core
The required foundation for most revenue cycle teams: Traditional Medicare coverage, medical necessity, coding, billing, and payment logic.
- Coverage & Authorization
- Coding & Billing Policy
- Payment across PFS, OPPS, ASC, CLFS, and DMEPOS
- NCCI, MUE, POS, modifier, and documentation guidance
- Source-linked rule change tracking
State Medicaid
State-specific Medicaid rules, manuals, fee schedules, prior authorization lists, and managed-care references where applicable.
- Ohio, Mississippi, California, and other state modules
- Complex states from $3,500/state/month
- State manual and fee-schedule maintenance
- Program-specific prior auth and billing guidance
- One-time activation from $3,000/state
Commercial Payers
Requested payer-family modules for commercial plans with product-specific prior auth, medical policy, and claim-rule nuance.
- Anthem Blue Cross, Cigna PPO, UHC Commercial, and more
- Plan/product variants from $750/month
- Payer policy and prior-auth source tracking
- Documentation and appeal caveats
- One-time activation from $5,000/payer family
Managed Payer Base
A managed implementation for teams that want RCI to build and maintain their payer base across Medicare, Medicaid, and commercial payers.
- Medicare Core included
- One state Medicaid module
- Three commercial payer families
- 25 workspace users
- Quarterly policy review and rollout support
What each paid workspace includes
Every payer module includes Coverage & Authorization, Coding & Billing Policy, and Payment. Service-group views like MRI/CT, Chemistry, E&M, outpatient procedures, and DMEPOS come with the modules — they are not billed separately.
Free developer evaluation
Product and engineering teams can test read-only endpoints, inspect request and response shapes, and evaluate fit in the API Playground before committing to anything.
Developer API access
Teams embedding RCI into their own products pay per call, with no seats or minimums.
| API call type | Price per call |
|---|---|
| Knowledge resolution | $0.01 |
| Layer lookup (single) | $0.005 |
| Billing guide | $0.01 |
| Payment calculation | $0.005 |
| Code research (AI agent) | $0.05 |
| Medical necessity (AI agent) | $0.05 |
| Denial resolution (AI agent) | $0.05 |
| Payer search | $0.005 |
| Rule change feed | $0.002 |