Blog
What payers actually pay, and how to find out.
Research for the people who run independent practices — owners, practice managers, and whoever owns revenue cycle in a small office. One piece a week. Every claim sourced, because these are money decisions and a number you can’t check is a number you shouldn’t act on.
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Same code, different pay: what 7 payers publish for office visits
The middle published rate for 99213, 99214 and 99215 at seven large payers, from their September 2026 Transparency in Coverage files: up to 45% apart between payers for the same visit, and wider still inside the national payers.
Payer Fee Schedules 2026: How to Get Yours
Why there is no single commercial fee schedule, where each payer publishes its negotiated rates under Transparency in Coverage, three ways to get your own 2026 rates, and a link to every payer RateBench reads.
99214 Reimbursement Rate 2026: What Payers Publish
The middle published rate and middle half for CPT 99214 at seven payers, from their September 2026 Transparency in Coverage files, what moves an individual practice’s rate, and how to check your own.
How to Spot Underpayments by CPT Code
A six-step check any practice can run from its own claims data: get a reference rate per code, export allowed amounts by code, compare, rank by dollars, rule out the usual explanations, and raise what is left with the payer.
Transparency in Coverage Files for Small Practices
What the federal Transparency in Coverage rules require health plans to publish, what an in-network rate file contains, why practices rarely use them, and how a small practice can use them to see, compare and check its own rates.
Allowed Amount vs Paid Amount vs Contracted Rate
What the contracted rate, the allowed amount and the paid amount each mean on a remittance line, why comparing payments to rates produces false alarms, and the one comparison that finds an underpayment.
Blue Cross Blue Shield Fee Schedule: Why There Isn’t One, and How to Find Yours
Why there is no single Blue Cross Blue Shield fee schedule: the Blue plans are independent companies with separate contracts, BlueCard prices out-of-area claims at the local plan’s rate, and each plan publishes its own negotiated rates.
Medicaid Fee Schedules by State: Where Each State Publishes Its Rates
A state-by-state index of where every Medicaid program publishes its fee-for-service fee schedule, with the 2026 federal publication requirement, the managed-care caveat, and how Medicaid rates compare with Medicare.
Contracted Rates: How to Find Yours by CPT Code
The three places a practice’s negotiated rate exists — the contract exhibit, the remittance advice, and the payer’s monthly Transparency in Coverage file — how to obtain each, and how to reconcile them when they disagree.