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Batching: today's rule and the 50-item rule
Today
No numeric cap in the regulation. All of these must hold:
- Billed by the same provider or group, facility or air ambulance provider.
- Paid by the same plan or issuer.
- The same or similar items and services.
- All furnished within the same 30-business-day period.
Under the amended rule
- Up to 50 items per dispute.
- Same provider (same NPI or TIN) or facility, and the same plan or issuer.
- And one of: one patient encounter, the same or a comparable code, or the same Category I CPT range for anesthesiology, radiology, pathology or laboratory.
- All within the same 30-business-day furnishing window.
When it applies
The cap and criteria apply to disputes whose open negotiation begins 90 calendar days after the Departments announce the new functionality is available. The revised definition of batched items applies to disputes whose open negotiation begins on or after November 1, 2026. Until then, use the current rule.
Sources: 45 CFR 149.510(c)(3), (c)(4), (a)(2)(i), (h)(1)-(3) on eCFR, read 2026-10-17. Not legal advice.