Yardstick Research tear-sheet / healthcare RCM cohort

Methodology · how we score · rubric weights in plain sight · vendors received this sheet seven days before publication and could flag factual errors, never rankings

Codametrix

Identity

CodaMetrix (legal entity CodaMetrix, Inc.; product CMX CARE). Founded 2019 as a spinout of the Mass General Physician Organization billing office. HQ: 399 Boylston St, Suite 700, Boston MA. ~139 employees (Feb 2026). $109M raised over Series A ($55M, Feb 2023, SignalFire), Series B ($40M, March 2024, Transformation Capital), and Series B-II ($11.65M, April 2025). CEO Hamid Tabatabaie (prior CEO of lifeIMAGE and Amicas). Ranked No. 1 in the inaugural 2026 Best in KLAS title for Autonomous Coding.

Total score: 81 / 100

(weighted dimension total = 81.25; pricing-transparency penalty = soft, ~1 point deduction → 80)

• Stage fit:
• Foundation (<40 readiness): conditional - overkill for greenfield buyers with no existing CAC; the platform layers over an incumbent CAC system and amortizes against existing coding cost baseline, so a buyer with no baseline can't compute the ROI case.
• Pilot (40-59): no - CodaMetrix is not structured for pilots in the SMB sense. Implementation requires enterprise EHR connectivity (Epic/Meditech/Cerner/GE) and an executive RCM buyer.
• Scale (60-79): yes - this is the sweet spot. A health system already running CAC, with multi-specialty coding volume, ready to convert manual coder labor into autonomous + reviewer headcount.
• Optimization (80+): yes - the largest IDNs and AMCs ($1B+ NPR, multi-state) are exactly the customer roster CodaMetrix already serves at scale.
• One-line verdict: The KLAS-ranked enterprise pick for autonomous medical coding at academic medical centers and large IDNs; bring it in when your RCM line item is in the tens of millions and your EHR is Epic, Meditech, Cerner, or GE.

Headline numbers

Dimension scores

Pricing detail

• Model: Custom enterprise SaaS contract. No published list price.
• No published per-encounter, per-coder, or per-tier economics. All cost figures in marketing are ROI framings (60% cost reduction, 5:1 ROI over 5 years, $750K annual savings at MGB radiology) drawn from vendor case studies - not list-price disclosure.
• No /pricing page at all (codametrix.com/pricing returns 404 as of research date).
• Pricing-transparency penalty: SOFT - vendor is unambiguously enterprise-only (size_fit_min = $500M NPR), and Wayback shows no prior published-pricing snapshot, so the rubric maps this to soft (not hard) per Section 6.7 of the research template.

Integrations

• EHR (native, vendor-claimed + corroborated): Epic (Epic Toolbox-certified August 2024), Meditech, Cerner, GE
• Hosting / cloud: AWS
• Clearinghouse partners: NONE publicly disclosed (CodaMetrix sits upstream of the clearinghouse - produces codes that downstream billing systems submit - so this may be by design)
• AVIA Marketplace listing: yes
• Marketplace presence: Epic Toolbox; AVIA Marketplace

Layer 4 stack-rank fields

layer4_fields:
  size_fit_min_revenue: 500
  size_fit_max_revenue: 50000
  ai_native_score: 75
  integrates_with: [epic, meditech, cerner]

Editorial assessment

CodaMetrix is the clearest enterprise pick in healthcare-RCM autonomous medical coding. The 2026 KLAS #1 ranking for Best in Autonomous Coding is the strongest independent procurement signal in the cohort - 93% would-repurchase and 8.0 likelihood-to-recommend across the customer panel, with named buyers spanning Mass General Brigham (the founding customer), Mayo Clinic, Yale Medicine, Henry Ford, Cedars-Sinai, UCSF, OHSU, UC San Diego, Dana-Farber, UMass, and Miami Health System. The platform genuinely scales to the top of the US health-system market: 500+ hospitals, 100K+ physicians, 60M+ annual encounters, $180B in aggregate net patient revenue. The MGB radiology case study (74% automation rate, 58.7% denial reduction, $750K annual savings, 12 FTE coders redeployed) is the most-cited deployment outcome and is internally consistent with the KLAS-validated customer-satisfaction signal.

The vendor wins workflow integration: Epic Toolbox certification (the cleanest tier of Epic partnership short of being an Epic-built module) plus Meditech, Cerner, and GE EHR connectivity, plus a "no workflow changes" layered-over-CAC deployment posture. For an Epic-shop AMC or IDN, this is the integration story a CIO can put in front of an EHR-governance committee without a fight. The vertical specialization is genuine - 7 specialties spanning both facility and professional fee coding, with the multi-specialty mandate baked in architecturally from the MGB origin rather than bolted on later.

Where the scoring marks down: data + compliance disclosure. The vendor publishes a SOC 2 + AWS badge in the site footer and nothing more - no public HITRUST attestation, no /trust page, no /security page, no named CISO, no BAA-language detail, no AI-training-data isolation policy. For a vendor processing PHI on 60M+ annual encounters at the largest US health systems, this is below the public disclosure bar a healthcare-RCM CISO will expect. The operational reality is almost certainly stronger - buyers like MGB and Mayo would not sign without HITRUST-equivalent diligence under NDA - but Yardstick scores what buyers can see, and the public surface is thin. A published trust page with HITRUST status, SOC 2 type+date, and pen-test cadence would shift the data-compliance dimension materially.

Where this vendor is the wrong answer: single-physician practices, ambulatory groups under ~10 providers, FQHCs / CHCs, and any buyer running a non-Epic/Meditech/Cerner/GE EHR. The pricing posture (custom enterprise, no published per-encounter economics), the customer roster (exclusively Honor Roll AMCs and large IDNs), and the multi-specialty architecture all amortize against scale. Below ~$500M annual NPR, the contract math doesn't work - buyers in that range should look at Fathom or Nym, both of which are explicitly positioned for the ambulatory and mid-market segments CodaMetrix does not serve.

When to revisit: (1) If a public HITRUST attestation or /trust page lands, re-rate the data-compliance dimension upward. (2) If a priced Series C closes at a disclosed valuation, resolve the B-II funding-ambiguity flag. (3) If an independent peer-reviewed or analyst-published accuracy audit lands, convert the 96% automation-rate claim from VENDOR-CLAIMED to corroborated. (4) If the company expands into the ambulatory or mid-market segment, the size_fit_min would re-rate downward.

Right-of-reply gaps

These are the [UNKNOWN] items the vendor should be invited to fill in during the factcheck pipeline:

• HITRUST CSF certification status (certified, in-progress, or not pursued?)
• SOC 2 Type (I or II) and most recent audit date
• Named CISO and security-program ownership structure
• Underlying LLM / model provider (proprietary, or external - OpenAI, Anthropic, Google, etc.) and whether customer PHI is excluded from model retraining
• Per-encounter, per-coder, or per-tier pricing economics - at minimum, a "starting at" anchor for the typical AMC contract
• Typical implementation duration (signed-contract to first autonomous-coded production claim)
• Pen-test cadence and report availability under NDA
• Series C plans and most recent disclosed valuation
• Structure of the April 2025 $11.65M Series B-II - bridge financing, organic extension, or strategic-investor allocation?
• Public /security or /trust page roadmap - is there a planned launch date?
• Whether the customer's coding decisions feed back into a shared model or a customer-isolated model
• Specific data-residency options (single AWS region, multi-region, customer-choice)