We’ve signed CMS’ Health Tech Ecosystem Stakeholder Pledge. Here’s what that means

Today The Centers for Medicare and Medicaid Services (CMS) Health Technology Ecosystem launched a pivotal new pledge category: Conversational AI Price Transparency in a broader effort to bring price transparency into every patient interaction. Turquoise is heeding the call from CMS and has signed the pledge. To celebrate, we’re launching our Consumer Pricing API.

Finally answering the unanswerable “How much will this cost me?”

The pledge is simple to state but hard to execute: a patient should be able to ask any AI app, in plain language, "How much will this cost me?" and get a real, personalized answer before they receive care. 

Unlike medical information, a healthcare price can't be looked up. It has to be computed. Healthcare prices vary too widely for a static average to mean anything. The same procedure can cost two otherwise identical patients dramatically different amounts, depending on their provider, insurance plan, and current benefits. That's the problem CMS is naming today: conversational AI needs new pricing infrastructure behind it, not just more data in front of it.

All about the API

This is where our Consumer Pricing API comes in—it powers patient-facing experiences that answer healthcare’s most unanswerable question:

“What will this procedure cost me?”

Turquoise’s Consumer Pricing API computes every price from three layers of precision, delivering an answer specific to that individual.

Identifies the right rates

Powered by Clear Rates™, our proprietary database of millions of negotiated commercial rates (refreshed monthly, cross-verified against what was actually paid, and confidence-scored). For every request, we select the exact rate for each procedure, provider, facility, payer, and network combination.

Priced the way care is actually billed

We don't simply price individual billing codes; we apply reimbursement methodologies derived from millions of real claims, reflecting how those codes are actually bundled and paid for in practice.

Applies the consumer’s real benefits

Factors in real-time deductible status, cost sharing, and out-of-pocket limits so the number reflects what the consumer will actually owe.

Whether embedded in a conversational AI assistant, a care navigation platform, or a scheduling workflow our API delivers personalized, insurance-aware price estimates instead of generic ranges.

Real consumer use cases now with real prices

Today, the API focuses on the most shoppable healthcare services: medium-to-high-cost procedures where patient responsibility isn’t fixed by a standard copay and provider choice can materially change their out-of-pocket costs (e.g., ACL repair, appendectomy, colonoscopy, CT scan, MRI). 

New services are added with every monthly release, with particular focus on the services required by Transparency in Coverage.

What’s next

Real prices in conversational AI are a momentous achievement, but, importantly, only one piece of our larger commitment to be active in an innovative community building open-source, open-license tools that deliver personalized, plain-language price estimates before patients receive care. Through the lens of the No Surprises Act, that means we must build an interoperable solution to scalably facilitate accurate Advanced Explanations of Benefits for insured patients and convened Good Faith Estimates for cash pay patients. It's hard to overstate how much momentum this CMS-led effort can create for making conversational AI the default way patients learn what care will cost. 

We also know getting to a world where any patient, in any app, can ask "what will this cost me?" and get a reliable, accurate upfront price will take a village. Our team is only one organization among many CMS is hoping will build workable products, and not just prototypes, for this future. 

If your organization works anywhere near conversational AI, price estimates, contracting, or patient cost transparency, take a few minutes to review what CMS has published. The invitation is open for others to take the pledge and help build the infrastructure for a healthcare transaction patients can actually talk to.