Section 1557 accessibility remediation cost in 2026

Our own pricing first, because a page about cost that hides its own is not worth reading: $299 flat for a single practice site, $499 flat to cover the website, the patient portal and the patient-facing documents together, and $19/month for ongoing monitoring afterwards. No hourly rate, no per-page meter, no discovery call before you are told a number.

The only cost figure the government has published

There is exactly one authoritative number on what this requirement costs, and it is in the regulator’s own arithmetic rather than in any vendor’s brochure. In the interim final rule of May 2026, HHS put the yearly annualized costs and benefits of the 2024 final rule’s web content and mobile accessibility section at $934.7 million and $1,265.6 million respectively.

Read that carefully, because it is easy to misuse. It is a national aggregate across every recipient of HHS federal financial assistance — hospital systems, community health centers, and single-physician practices in the same total. It is not a per-practice estimate, and dividing it by a recipient count does not produce one. Any vendor quoting you “the HHS estimate” for your practice specifically has made a number up. We are not going to do that either. What the figure is genuinely good for is calibration: a regulator that scores its own rule as returning more benefit than it costs is not a regulator preparing to withdraw it.

The extra year is a deferral, not a discount

The most expensive misreading of the 2026 extension is that it made the work smaller. HHS scored it as pure timing. The interim final rule estimates the delay lowers annualized costs by $114.3 million at a 7 percent discount rate and $93.3 million at 3 percent, while lowering annualized benefits by $204.6 million. The department gave up more in benefit than it saved in cost and did it anyway — which tells you the extension was about recipient readiness, not about doubt over the requirement.

So the bill did not shrink. It moved to 11 May 2027 for recipients with 15 or more employees and 10 May 2028 below that threshold. A practice treating the extra year as a reason to spend less is disagreeing with its own regulator’s published arithmetic. Where those dates actually live in the regulations matters too, and it is not where most practices assume.

What actually moves a quote

Three things, in descending order of how much money they represent.

• The patient portal. It is almost always a vendor product whose code you cannot edit. A vendor quoting to “remediate your portal” is either pricing work they are not in a position to perform or quietly excluding the portal while leaving you to assume otherwise. What can honestly be bought here is testing, a written record of what conforms and what does not, and a vendor conversation started early enough that a contractual answer is still available to you. Who is actually responsible for the portal is settled by the regulation rather than by your contract, and it is worth reading before you price this line.
• The document backlog. Intake forms, after-visit summaries, financial policies, consent forms. Most vendors price these per document, which is why a practice with a decade of scanned PDFs can receive a quote an order of magnitude above a neighbouring practice with the same website. Anyone quoting your documents without having counted them is guessing.
• Fix versus evidence. Some quotes buy remediation. Some buy a dated, attributable record that remediation happened and what it was tested against. If you are ever asked to demonstrate compliance, only the second one is responsive — and a fix with no record of itself has to be re-proven from scratch.

Is there a published market rate for Section 1557 remediation?

Essentially no. Almost every vendor in this market quotes privately, and the few that post figures do not price on the same unit, so the posted numbers cannot be averaged into a rate. What follows is every published price we could find, which is a short list.

How short is worth stating plainly, because it is the finding. Vispero — the company that makes JAWS, the screen reader much of this testing is performed with, and that sells audits, VPATs and PDF remediation into healthcare — names Section 1557 and patient portals on its own healthcare page and posts no rate anywhere on it. Neither does Braille Works. When two of the better-known names serving this exact buyer publish nothing, a practice trying to sanity-check a quote against “the going rate” is not being lazy; there is genuinely no published rate to check it against.

Accessible.org is the only vendor publishing per-page audit rates — $100–$250 for primary pages and $25–$100 for light ones — and it also states a total: “Most accessibility audits cost between $1,250 and $2,750.” Read the total and the unit together, because they constrain each other: that band implies roughly five to twenty-seven primary pages, a smaller site than most practices have. It also buys an audit, not the remediation that follows one, and document remediation is metered separately, from $7.00 a page and from $7.50 for PDFs. Its pricing page does not mention healthcare, hospitals, patient portals or Section 1557 anywhere.

The subscription vendors post lower headline numbers for a different deliverable. Practis charges $65/month for automated scanning and reporting and $125/month with remediation included, and says plainly that “some accessibility issues require human judgment and cannot be tested automatically.” AllAccessible runs healthcare plans from $10/month to $99/month. Both are ongoing monitoring products; neither is a dated conformance record for a fixed scope.

Which is the actual finding: the spread between $10 a month and five figures is not a spread in price for one job, it is four different jobs wearing the same words. The full side-by-side of what each vendor publishes sets out the pricing units in a table.

Questions worth asking any vendor

Is the patient portal inside or outside this number, in writing? Are documents priced per document, and against what count? Does the price include re-testing after we make the changes, or is that a second engagement? What do we physically receive at the end — a report, or something dated and attributable we could hand to counsel? A vendor who answers all four in a quote is not necessarily cheaper, but they are quoting the same job you are buying.

What CivicBinder Health charges, and what it is

The binder audits the website, the patient portal and the patient-facing documents against WCAG 2.1 Levels A and AA, records what was tested and what was found, and gives remediation instructions written for the templates and documents you actually have — dated and attributable, so the work is evidenced rather than asserted. That is the whole product; there is no tier above it.

$299 for a single practice site, $499 covering website, portal and documents, $19/month for monitoring afterwards. Request a free scan first if you would rather see where you stand before spending anything — public surfaces only, no patient data.

For what everyone else charges rather than what HHS scored, four vendors’ published prices side by side works through the per-page, per-month and flat pricing units on real posted rates.

Cost and benefit figures, the discount rates and the compliance dates verified on 29 July 2026 against the published text of the interim final rule (91 FR, doc. 2026-09266), which cites the 2024 final rule at 89 FR 40066, and re-confirmed on 12 August 2026 as still the operative instrument. Every competitor price above was re-read from the vendor’s own published pricing page on 12 August 2026; list prices change without notice, so check them before relying on one. Our own fees are set by us and are not sourced to anyone. Nothing here is legal advice.