The homepage Rate Lookup tool calculates estimates in the browser from the same four building blocks described on the product. Operators, counsel, and search engines can read that method here without running the filters.
Anchor Rate
Each plan’s anchor for CPT 90837 (psychotherapy 60 min, PhD/PsyD) is modeled from CMS Transparency in Coverage machine-readable files, the negotiated rates payers are required to publish.
Relative Value
Each CPT/HCPCS code is scaled against 90837. Medicare-covered codes use CMS RVU ratios. HCPCS H-codes without a Medicare reference use commercial market averages from published price transparency files.
Geographic Adjustment
Rates are adjusted by CMS Geographic Practice Cost Index (GPCI) by state, reflecting regional differences in cost of living, malpractice premiums, and practice expense.
Credential Factor
Each credential type has a multiplier relative to the PhD/PsyD anchor. MD/DO typically models near 104–105%; master’s-level clinicians near 79–85%; BCBA at parity. Factors are derived from price transparency file benchmarks.
What the model does and does not do
- It estimates a typical commercial or Medicaid fee-schedule position for a code, state, plan family, and credential, not a specific NPI’s contracted allowed amount.
- Prescriber-only codes (E/M 99213–99215 and 90792) apply to MD/DO and PMHNP in the tool. Other credentials show as not applicable.
- ABA codes (97151, 97153, 97155, 97156) apply to the BCBA credential and are billed in 15-minute units. ABA schedules are often negotiated separately; treat those rows as estimates.
- H0001 and H0004 are HCPCS Level II codes. Commercial coverage and CADC/LADC panel rules vary by plan.
- Medicaid rows are fee-schedule-style estimates (Medicare × a state Medicaid/Medicare ratio, with published research and selected state fee schedules used as reference). Medicaid is modeled as the same rate regardless of credential. H-codes and ABA codes have no Medicare reference in the model; a national CMS claims average is used instead.
Verification
Source publications (CMS Physician Fee Schedule, Transparency in Coverage machine-readable files, GPCI, and state Medicaid fee schedules) are updated by the agencies that publish them. Parite reviews those publications as they change. Last-verified dates live on each official cell, because a single sitewide date would go stale the moment an upstream file is republished.
Always confirm the current published file and your own payer contract or provider portal before a contracting decision. See Data Sources for the public inputs we cite.
SSR hubs for official Medicare amounts
Psychotherapy codes have server-rendered hubs at /rates, /rates/{code}, and /rates/{code}/{state}. Medicare columns are calculated from CMS RVU26D (October 2026 Relative Value file) and Addendum E GPCIs. Medicaid FFS columns are parsed from official state files; see Data Sources. A hub is indexed when both Medicare and a Medicaid FFS cell exist for that code (and, on state hubs, that state). Medicare and Medicaid fee-for-service amounts come from those published schedules. UnitedHealthcare medians come from the published Transparency in Coverage in-network file when we have parsed it. Aetna and Anthem commercial rates stay Coming soon.
The homepage commercial / credential table prefers a fetched UHC professional median when a cell exists for the selected state×CPT (Ohio 90837 → $139.72), still behind the Stripe paywall. Aetna and Anthem stay modeled or Coming soon and are not labeled as official published rates. Official Medicare is free on the homepage panel and on the hub pages.