Accreditation Fees

Accreditation fees are based on an organization’s annual revenue.

Each year, Accredited Organizations must submit an Annual Revenue financial Verification.  For new organizations, this is submitted as part of the application process.

How to Determine an Organization’s Size

Organization annual revenue is defined as any and all revenue collected annually for services performed whether electronically or manually, that supports the program being applied for. This includes all services related to electronic transactions, patient statements, customer service, infrastructure, technical performance, business practices, privacy and security and resources.

The revenue from banking/financial organizations is based upon the size of their treasury management operations which is responsible for the healthcare services business line. Healthcare trading partners include such entities as providers (such as physicians and hospitals), labs and ancillary professionals, health plans, medical supplies/distributors and pharmaceuticals.

Note: Proof of six month’s operating revenue must be provided to be considered for accreditation.

DirectTrust/EHNAC Accreditation Fees Beginning in 2024

As we continue our incorporation of EHNAC into DirectTrust, we’ve spent a great deal of time reviewing the Accreditation Fees and we are updating our fee structure to be effective January 1, 2024. Our new Accreditation Fee structure is designed for scalability for organizations of varying sizes and program pursuits. As such, the structure contains several different types of fees which are outlined on the DirectTrust website.

Please visit the DirectTrust site here for fees for 2024. 

The remainder of information on this page is relevant for 2023 Fees.

Current Fees (Ending in 2023)

SizeRevenue AmountAnnual FeeMultiple Program FeeSite Visit Fee/Site/Day
Very SmallUnder $3M$3250$1625$5000
SmallGreater Than $3 Less Than $8M$4250$2125$5000
MediumGreater Than $8 Less Than $20M$8500$4250$8000
Med/LargeGreater Than $20 Less Than $50M$13000$6500$8000
LargeGreater Than $50M Less Than $75M$20000$10000$8000
Very LargeGreater Than $75M$26500$13250$8000

 Federal, state, and non-profit organizations are included in the Small Size above.

Note:  If an organization selects the HITRUST version of the criteria and the organization does not currently have HITRUST certification there is an additional Site Visit Day Fee.

Each site visit review fee is considered one day.  Site Visits can be either virtual or at the site.

Annual Fee

For Accredited organizations, the Annual Fee is due every year prior to the anniversary of the accreditation date.  For new organizations, this is paid as part of the applicant process.

Site Visit Fee

For new applicants, the Site Visit Fee must be paid along with the Annual Fee as part of the application process. For reaccreditations, the Site Visit Fee is due no later than 8 months prior to the accreditation expiration date, as part of the application process.

Midterm Accreditation Fee

DirectTrust offers Midterm Accreditation review for organizations wishing to pursue this.  The fee is $4,000 per program.

Multiple Program Fee

The Multiple Program Fee occurs when an organization applies for accreditation for more than one program. The Multiple Program Fee applies to each additional program(s) applied for and is based on the organization’s combined program revenues. This fee (or fees) is paid on the organization’s accreditation year (the same time schedule as the site visit fee).  The Following programs are not applicable for the Multiple Program Fee: CCCAP,  OSAP, and TDRAAP-Basic.

*Carin Code of Conduct (CCCAP)

The Annual Fee is $3,250 for all organizations regardless of the revenue.  The Review Fee is $4,000 regardless of the revenue.  Multiple Program Fee not applicable.

**EPCSCP-Pharmacy and EPCSCP-Prescribing Fees

ECPSCP Annual Fee $3,250 is paid annually, and the Review Fee $4,000 is paid every 2 years with the certification.  There is no site visit required for ECPSCP.  The Annual Fee is $3,250 per organization regardless of revenue.  If an organization wishes to certify both EPCSCP-Pharmacy and EPCSCP-Prescribing as a second Certification program or has multiple versions there is an EPCS Multiple Program Fee of $1,625 every two years and an additional Review Fee of $4,000.  The Multiple Program Fee does not apply to other accreditation programs.

***Outsourced Program (OSAP)

The Annual Fee is for this program is $4,250 per organization regardless of revenue. The Site Visit Fee is $5,000 per site regardless of the revenue.  Multiple Program Fee not applicable.

TDRAAP-Basic Certification Fees

This $1,200 fee is paid annually for the 1-year certification.  Multiple Program Fee not applicable.

Re-accreditation Fees

The fee categories are the same for each accreditation program. The Annual Fee is paid each year and all other fees are due every other year on the accreditation date.

Site Visit Fees for Sites Outside the US

Site Visit Fees for sites that are Outside of the US are $4000 per day in addition to the standard Site Visit per day Fees (plus travel expenses).  See International Travel Process for additional fee details.  See International Accreditation page for definitions and details.  Travel expenses are not included and will be invoiced after the site visit(s).

Accredited Organizations Adding New Programs between Accreditation Cycles

If an accredited organization indicates a desire to add an additional program [other than EPCS] between accreditation cycles, and has the same sites to review, the Multiple Program Fee will apply, and a $3,000 desk review fee is also assessed. If there are additional sites to review, then the applicable Site Visit Fee and associated travel expense costs apply.

If the new program is added prior to the 1-year accreditation anniversary, then it will be included in present/current accreditation. If the new program is added post the 1-year accreditation anniversary, then the candidate is accredited and bypasses the next accreditation cycle, unless there are changes.  This does not, however, apply to EPCS where the certification cycle cannot exceed 2 years.

Example: If the accreditation date is 6/1/20 and the new program is added before 6/1/21 it will be incorporated into the current [2020] accreditation cycle and be included in the next [2022] accreditation. If the new program is added after 6/1/21 only changes will need to be reported during the next [2022] accreditation and it will be incorporated into the following [2024] accreditation cycle.

Other Fees

In addition to the Review Fee, when a self-assessment process requires subsequent resubmissions of the documentation to meet the criteria after the site visit is completed, there will be a charge of $225/hours for the assessor time per additional submission of documentation.

Lockbox Site Visits

For organizations with multiple lockbox facilities and for OSAP applicants that have sites that perform the same function, and which demonstrate adherence to the same policies and procedures, a site visit rotation will be used to accredit the candidate as shown in the following table. NOTE: The table below is provided as a guideline only, as the number of sites requiring a visit may be increased based on such factors as newly acquired sites, sites that do not currently comply with standard policies and procedures, or other factors where additional visits are determined to be required.

No. of SitesSite Visits RequiredNo. of SitesSite Visits RequiredNo. of SitesSite Visits RequiredNo. of SitesSite Visits Required

Estimated Fees

To compute your estimated fees, please click here for a cost calculation table.