Every rate we publish can be traced to a specific file, published by a specific insurer, in a specific month. This page explains the pipeline in plain language, including the parts where we tell you what we don't know.
Since July 2022, the federal Transparency in Coverage rule has required health insurers to publish machine-readable files listing their negotiated in-network rates. These files are public by law, republished monthly, and enormous: a single payer's monthly disclosure can run to hundreds of gigabytes. They were designed for compliance, not for reading.
Raw payer files are full of "ghost rates": contracted amounts listed for provider-and-service combinations that never occur in real life (a psychologist with a listed rate for cardiac surgery, because the payer dumped its entire fee schedule against every provider in its network). Reporting raw files as market data would be wrong.
So: we filter to behavioral-health provider taxonomies; we cross-check against public anchors, including Medicare's published fee schedule for the same codes and locality, and exclude implausible outliers; and we compute medians and 25th–75th percentile ranges rather than single "the rate is X" claims, because markets are ranges.
Every figure carries a grade based on the number of independent contracted rates observed behind it. High confidence means hundreds to thousands of observations. Where a payer's file quality or volume is too low to support a trustworthy number, the cell says so; we publish "insufficient data" rather than a guess.
Payers republish their files monthly, and every campaign is stamped with the month of the files it was built from. If you buy a campaign built on files older than 60 days, we'll rerun it on current data free.
You hold one number we can't see: your own contracted rate. Check it against the range we report for your payer and code. If your verified rate falls far outside a range we report with high confidence, tell us. That's a refund and a bug report, and we mean both.
Market information, not legal, billing, or contracting advice. Medians describe markets, not any individual contract, and no negotiation outcome is guaranteed. PracticeRates is independent and not affiliated with, or endorsed by, any insurer.