MTF User Resources for Manufacturers
The Medicare Transaction Facilitator User Guide is available at the following link for download: MTF User Guide (June 9, 2025) (PDF). For a step-by-step demonstration of the MTF enrollment and user management processes for manufacturers, watch this video: MTF Manufacturer Enrollment Process.
Medicare Transaction Facilitator (MTF) Agreements
The Medicare Transaction Facilitator (MTF) User Agreements outline the responsibilities of each party that will be engaged in the Medicare Transaction Facilitator, a core component of implementing the Medicare Drug Price Negotiation Program. CMS has finalized the agreements based on public feedback as well as input from the MTF contractors involved in the development and operations of the MTF system. The final MTF agreements are being made available for preview. These User Agreements will be electronically signed by an authorized individual from each enrolling dispensing entity and Primary Manufacturer during the MTF onboarding process. For more information about these agreements, see the FAQs here (PDF).
- Final MTF agreements and a summary describing the public feedback received are available here:
- MTF Data Module User Agreement for Primary Manufacturers (PDF)
- MTF Payment Module User Agreement for Participating Primary Manufacturers (PDF)
- MTF Data Module User Agreement for Dispensing Entities (PDF)
- Summary of Public Feedback and CMS’ Responses on the Draft MTF Agreements (PDF)
- Public Feedback letters (PDF)
MTF Development Milestones
CMS is currently developing a Medicare Transaction Facilitator (MTF) to support effectuation of the negotiated maximum fair prices. A timeline for the major milestones for the system development process is available here (PDF).
Manufacturer Frequently Asked Questions (FAQ)
This FAQ resource addresses inquiries that CMS has received from Primary Manufacturers participating in the Medicare Drug Price Negotiation Program. CMS will share additional information on manufacturer-initiated claims reversals, the credit/debit ledger system, and other operational details in forthcoming FAQs and technical instructions. The FAQ document is available here (PDF).
MTF Information Collection Request
The ICR for the Medicare Transaction Facilitator for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA) is now available. This ICR previously underwent a 60-day public comment period, concluding on December 27, 2024 and a 30-day comment period, concluding on May 1, 2025; CMS revised this ICR based on public comments and the Office of Management and Budget (OMB) has approved the finalized ICR package (OMB control number 0938-1483). The final ICR is available for viewing on OMB's website. Click "all" to see full details.
The Manufacturer MFP Effectuation Plan Form template is available at the following link: MFP Effectuation Plan Form Template (PDF).
MTF Interface Control Documents (ICDs)
The Medicare Transaction Facilitator Data Module (MTF DM) is the system through which drug manufacturers participate in the Medicare Drug Price Negotiation Program. The MTF DM facilitates the secure exchange of data between CMS, drug manufacturers and dispensing entities. The ICDs included in this section define the data elements used in MTF claims and claim payments.
MTF Manufacturer Data Exchange Technical Documentation
This document provides technical specifications, security requirements and procedural guidance for drug manufacturers using the Medicare Transaction Facilitator (MTF) Data Module (DM), including instructions for Amazon Web Services (AWS) S3 for file exchange. The document is available here (PDF).
MTF Manufacturer Refund Notice (MRN) and Manufacturer Refund Advice (MRA) ICD
The MRN, MRA, and MRR data are included within a single file exchanged between the MTF DM system and drug manufacturers, as frequently as daily.
The MRN portion communicates refund information from the MTF DM to drug manufacturers, including the amount due based on the calculated Standard Default Refund Amount (SDRA) if a Wholesale Acquisition Cost (WAC) is available. Drug manufacturers process the MRN data and return the file to the MTF DM system with the completed MRA section within 14 days.
The MRA portion includes remittance instructions from the drug manufacturer to the MTF DM system regarding the correct payment amounts (if applicable) to be distributed. The MTF DM system then transmits instructions to the MTF Payment Module (MTF PM) for remittance to dispensing entities.
The MRR portion will provide a notice to the Primary Manufacturer that acknowledges receipt and processing of MRA elements (also referred to as the claim-level payment elements) by the MTF DM. For MFP refund payments facilitated through the MTF PM, the file will include information on MFP refund payment status, payment amounts, and the application of any credits when applicable. As described in sections 40.4.3.2 and 40.4.4.2 of 2028 draft guidance (PDF), CMS is soliciting comments on content for the receipt file that would be informative for Primary Manufacturers.
MTF MRN/MRA ICD (zip) (ZIP) (June 10, 2025)