Benchmark negotiated rates for mental health, SUD, and ABA services across all 50 states, 300+ health plans, and 8 credential types. Built on CMS Transparency in Coverage data.
50States
300+Health Plans
23CPT & HCPCS Codes
8Credential Types
⚠ Prescriber-only codes: E/M codes (99213–99215) and 90792 are billed by MD/DO & PMHNP only. Other credentials show N/A for these codes.
ⓘ ABA codes (97151, 97153, 97155, 97156) apply to BCBA credential only and are billed in 15-minute units. Rates shown are per unit. ABA fee schedules are negotiated separately — treat as estimates.
ⓘ H0001 & H0004 are HCPCS Level II codes (not CPT). Commercial payer coverage varies significantly. H0004 is billed per 15-min unit. CADC/LADC panel acceptance also varies by plan.
ⓘ Medicaid rates are fee-schedule-based estimates: Medicare rate × state Medicaid/Medicare ratio (source: Zhu et al. 2023, Health Affairs; confirmed state fee schedules for CO, NM, NY, VA). Select a state to see state-specific estimates. H0001, H0004, and ABA codes have no Medicare reference — national CMS claims average is used instead. Medicaid pays the same rate regardless of credential type.
Code
Description
Category
Health Plan
Credential
Est. Rate
Select a state, code, or credential to view estimated rates
Click any state to filter all views to that market.
Payer comparison for selected code & credential (defaults to 90837 / PhD/PsyD). Select a state to see state-specific plans.
Rate comparison across all credential types for the selected code and state.
Methodology
How rates are estimated
Anchor Rate
Each plan's anchor rate for CPT 90837 (Psychotherapy 60 min, PhD/PsyD) is sourced from CMS Transparency in Coverage machine-readable files — the actual negotiated rates payers are legally required to publish.
Relative Value
Each CPT/HCPCS code carries a relative value benchmarked against 90837. Medicare-covered codes use CMS RVU ratios. HCPCS H-codes (no Medicare reference) use commercial market averages from published MRF data.
Geographic Adjustment
Rates are adjusted by CMS Geographic Practice Cost Index (GPCI) per state, reflecting regional differences in cost of living, malpractice premiums, and practice expenses across all 50 markets.
Credential Factor
Each credential type commands a different rate multiplier relative to PhD/PsyD anchor. MD/DO typically bills at 104–105%; master's-level clinicians at 79–85%; BCBA at parity. Factors are derived from MRF benchmarks.
Data Sources
CMS Transparency in Coverage MRFsMedicare Physician Fee Schedule (MPFS)CMS Geographic Practice Cost IndexSapphire MRF Hub (BCBS plans)Commercial ABA market benchmarks
Market Intelligence
Analyze payer rates by market to identify contracting opportunities. All data sourced from CMS Transparency in Coverage machine-readable files and the Medicare Physician Fee Schedule.
Payers ranked highest to lowest by their negotiated rate for the selected state and credential. Rates are GPCI-adjusted from TiC MRF anchor rates.
Loading…
📋 Multi-Code Rate Comparison — Big 5 National Payers
Rates for key therapy and evaluation codes across UHC, Anthem, Aetna, Cigna, and Humana, adjusted for the selected state and credential. National averages used when no state is selected.
Loading…
⚠️ Medicaid vs. Commercial Rate Gap — All States
Compares the best available commercial rate (LCSW, 90837) vs. the Medicaid FFS estimate for each state. States sorted by largest gap. Identifies markets where providers accepting Medicaid face the greatest revenue gap.
Loading…
🏢 Competitor Provider Group Rate Intelligence
Estimated negotiated rates for major behavioral health provider groups vs. the market benchmark. Rates are tier-estimated from CMS TiC MRF data and public earnings disclosures. Look up any group by NPI to compare against the benchmark.
Type a name to search the NPPES registry for any behavioral health organization. Any group over ~20 providers can be found and compared against the market benchmark. Or enter a 10-digit NPI for a direct lookup.
Unlock Behavioral Health Rate Intelligence
Get full access to negotiated rates across 50 states, 300+ health plans, and comprehensive market intelligence for your organization.
Free Preview
$0 /month
See a sample of rate data to evaluate the platform.
1 CPT code (90837) in 1 state (California)
Rates for 3 major payers
Top 3 BH competitor groups in Market Intelligence
Limited filter options
Most Popular
Enterprise
$10,000 /year
Full access to all rate intelligence data and market tools.
All 23 CPT & HCPCS codes
All 50 states with GPCI adjustment
300+ health plans including Medicaid
8 credential types with rate factors
Full Market Intelligence module
Competitor provider group analysis
NPI search & benchmarking
Medicaid vs. commercial gap analysis
Cancel anytime. No long-term commitment required.
Questions? Contact us at sales@parite.com
Create Your Account
Sign up to subscribe and unlock full access to Parite rate intelligence.