Every insurer publishes its negotiated rates in files no clinician has time to read. We read them, grade them, and turn them into the letters, contacts, and follow-up scripts that raise yours.
The payer across the table can see every contract in your market. You can see one: yours.
That's why panel decisions get made on rumor, why renewal letters get signed unread, and why 40% of provider organizations still negotiate without market data; most say they simply don't have the time or tools to extract it.
The data became public in 2022, buried in terabyte-scale files built for compliance, not for reading. Reading them is our entire job: filtered to behavioral health, cleaned of ghost rates, graded by confidence, refreshed monthly.
That's the entire setup. No EHR connection, no billing files, no patient data, ever. Type your current rates from your own fee schedule if you want your exact percentile.
Median rates, 25th–75th percentile ranges, and confidence grades for every payer and code, from this month's federally mandated files, cleaned of the junk entries that make raw data unusable.
Percentile per payer, annual dollars at stake at your volume, a defensible target rate, payer-specific letters, the correct submission channel, and follow-up scripts for when payers go quiet.
Know which payers pay top-of-market before you spend 90 days credentialing with the wrong one.
Your percentile plus a ready-to-send letter citing market medians, with your numbers already in it.
Your Headway or Alma per-session rate versus direct-contract medians: what the middleman actually costs or saves you.
Under the federal Transparency in Coverage rule, every payer publishes machine-readable files of negotiated rates each month. Public by law, and enormous, messy, unreadable. Our job is the reading.
Raw files list "ghost rates": amounts for services a provider never performs. We filter to behavioral-health taxonomies, remove implausible outliers, and grade every figure by the observations behind it. Where a payer's file is too poor to trust, we say so instead of reporting it.
Every campaign names its source files and data month. Better: check the one number you already know, your own contracted rate, against our data before you rely on the rest.
From the machine-readable files insurers publish monthly under the federal Transparency in Coverage rule (in effect since July 2022). We extract, clean, and analyze them. Nothing is scraped from anywhere it shouldn't be, and nothing involves patient data.
Yes. The files are published by insurers because federal regulation requires it; that's their entire purpose. We analyze public regulatory disclosures, the same way financial analysts read SEC filings.
No, and you never will. You give us a specialty and a zip code. For your exact percentile, you type your current rate from your own fee schedule. No integrations, no logins, no patient information, by design.
Payers republish files monthly, and every campaign states the exact month of the files it was built from. If yours was built on data older than 60 days, we rerun it on current files free.
Most tools sell raw data to developers, serve solo clinicians with a handful of national payers, or serve large facilities and private equity. PracticeRates is built for working practices, solo through 50 clinicians, with the regional payers that dominate your market (starting with BCBS IL), monitoring that keeps working at every renewal, and outcomes recorded over time so recommendations reflect what payers recently agreed to, not just what their files claim.
If the data in your campaign is materially wrong for your market (for instance, your own verified contracted rate falls far outside a range we report with high confidence), email us within 30 days and we refund in full. No forms, no argument.