Context4 Reference-Based Pricing

Accurate data and cutting-edge cloud technology combine to create a proven and defensible Medicare reference-based pricing (RBP) solution.

Reference-Based Pricing Simplified


Accurate, Proven, and Defensible

Health plans need reference-based pricing (RBP) that’s accurate, proven, and defensible ­– otherwise, they face pushback from providers, balance billing to members, and dissatisfaction for the employer group. But RBP calculations for reimbursement are often complex, inconsistent, and confusing.

Context4 Reference-Based Pricing makes reference-based pricing simple. We’re leading the way in the new age of healthcare pricing with our in-depth, accurate data and cutting-edge cloud technology. These ingredients combine to deliver a proven, defensible healthcare pricing solution with total Medicare gap-fill and unmatched accuracy.

Comprehensive and Adaptable

If it’s Medicare reference-based pricing (RBP) you need, Context4 Reference-Based Pricing uses the CMS Prospective Payment Systems within our real-time processing engine to calculate the pricing. For UCR RBP, we use our industry-leading UCR data. Either way, you get accurate and real-time pricing results.

Context4 Reference-Based Pricing is part of the Context4 Health Plans Suite, our modular, integrated technology platform. Implementation is effortless, and the service is secure, immediate, and reliable.


The Complete RBP Solution

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All Medicare Prospective Payment Systems (PPS), fully automated

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Context’s leading UCR fee data

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The ability to have the solution return a percent of Medicare to you

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Cloud-based for easy implementation

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Updated weekly

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No data to manage or software to maintain

Contact us to learn more about what true Medicare Reference-Based Pricing can do for your organization.