Rate Lookup uses the published files below. Open a hub when you want the dollar cells themselves.
CMS Physician Fee Schedule (MPFS)
The Medicare Physician Fee Schedule published by the Centers for Medicare & Medicaid Services is the public reference for RVU-based relative value on Medicare-covered CPT codes. Official rate hubs use the RVU26D October 2026 Relative Value file (CMS file dated 2026-08-26, effective 2026-10-01 through 2026-12-31) plus Addendum E GPCIs. Payment is work, practice-expense, and malpractice RVUs, each multiplied by the matching GPCI, then by the CY 2026 non-QP conversion factor 33.4009.
Official files: RVU26D ยท PFS Relative Value Files.
Transparency in Coverage machine-readable files
Federal Transparency in Coverage rules require group health plans and issuers to publish machine-readable files of in-network negotiated rates. Parite has loaded UnitedHealthcare Optum Health Behavioral Services professional percentiles for CPT 90837, 90834, 90832, and 90791 in 50 states plus DC. Ohio 90837 UHC median is $139.72. Nebraska 90837 is $147.07 and Alaska 90837 is $146.12. Indiana 90837 is $139.72 and South Carolina 90837 is $135.85. Arizona 90837 is $130.42 and Massachusetts 90837 is $147.07. Pennsylvania, Illinois, and other loaded states are on their UnitedHealthcare state pages. Medicare amounts use the CMS Physician Fee Schedule. Medicaid amounts use that state's published fee-for-service schedule when parsed. Aetna, Anthem, Cigna, and Humana commercial columns stay Coming soon until those files are live.
See UnitedHealthcare price transparency, UHC Ohio, UHC Pennsylvania, UHC Arizona, and the Contract Checker. Background: cms.gov/healthplan-price-transparency.
How to cite Parite
Suggested citation: Parite. UnitedHealthcare Optum Behavioral Health medians by state. Source: UnitedHealthcare Transparency in Coverage in-network file (Optum Behavioral Health), as of 2026-09-01. https://goparite.com/data/uhc-bh-medians-by-state.csv
The CSV columns are state, CPT, p10, median, p90, source, as-of date (p10 and p90 are the 10th and 90th percentiles) for UnitedHealthcare only. Aetna and Anthem are not in the file.
CMS Geographic Practice Cost Index (GPCI)
GPCI values adjust Medicare payment by locality for work, practice expense, and malpractice. The tool applies a state-level GPCI-style adjustment so the same plan family is not shown as geographically flat across all 50 states.
State Medicaid fee schedules
Official Medicaid FFS professional schedules are parsed for 24 jurisdictions, including Ohio, Michigan, California, Texas, Florida, New York, Illinois, Virginia, Washington, Arizona, Oklahoma, Kentucky, Indiana, Missouri, Louisiana, South Carolina, Nevada, Alaska, Mississippi, Nebraska, West Virginia, North Dakota, Montana, and the District of Columbia. State hubs live at Medicaid FFS. Codes a state does not publish stay empty. Medicaid MCO rates stay Coming soon.
The homepage Rate Lookup tool still has a separate modeled Medicaid estimate path (Medicare times a research ratio). Official Medicaid FFS amounts on the rate hubs come from the published state files, not that model.
Other published inputs
- Sapphire MRF Hub for Blue Cross Blue Shield plan files, as noted on the homepage data strip.
- Commercial ABA market benchmarks for codes that are often carved out of standard professional fee schedules.
- Zhu et al., 2023, Health Affairs, cited on the homepage as a published reference for Medicaid/Medicare payment ratios used in the Medicaid estimate path.
- CMS National Plan and Provider Enumeration System (NPPES) for optional organization NPI lookup in Market Intelligence.
How to read dates on the hubs
CMS and state agencies republish these files on their own calendars. Each official cell shows when Parite last checked that source. Re-check the upstream publication before a contracting decision. UnitedHealthcare medians appear when that file is parsed; Aetna and Anthem stay Coming soon.