Fee schedule
Your contracted rates, payer by payer, by CPT code.
Enter your NPI and the codes you bill. We read the rate each payer published for your practice and lay them out in one sheet: codes down the side, one column per payer, the source behind every number.
On every paid plan, from $99/month · cancel anytime
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Why it’s hard to find
Your fee schedule isn’t one document.
Ask for your insurance fee schedule and you’ll find there isn’t one. Every payer you take has its own rates for you, and they can differ by network: an HMO and a PPO product from the same payer can pay the same visit differently. The rates are tied to your NPI or your tax ID, not to a published price list everyone shares. That’s why searching for a payer’s fee schedule turns up nothing you can use.
Your own charges don’t answer it either. What you bill is your price; what you’re paid is each payer’s contracted rate. The contract that holds it is often years old, with a rate exhibit nobody can find, or a line that says rates follow the payer’s schedule.
Practices that do have their rates usually rebuilt them by hand from remittances, one payer at a time. How to find your contracted rate →
Where the numbers come from
The payers’ own files, read for you.
Since 2022, the federal Transparency in Coverage rule has required commercial payers to publish the rates they agreed with every in-network provider, by NPI and tax ID, and to republish them every month. The files are machine-readable and enormous, often gigabytes per payer. We read them and keep only what is about you.
Every figure shows
- The professional, in-office rate each payer published for your NPI
- Which network it belongs to, since an HMO and a PPO product can differ
- How it’s priced: negotiated, the payer’s own fee schedule, or “derived”, flagged as an estimate
- The month of the file and a link to the file itself
- Medicare’s own amount for your pricing area, beside your commercial payers
- Your practice’s rates only, when you add your tax ID and your clinicians also work under other contracts
It won’t
- Invent a national benchmark or a “market rate”
- Cover Medicaid or Medicare Advantage, since neither is published in these files
- Show facility or institutional rates
- Read payers we haven’t verified end to end. See coverage
- Put a dollar figure on a code the payer prices as a percentage of charges. It says so instead
How it works
Four steps, and minutes for most payers.
- 01
Your NPI, your codes, your payers
Enter your billing NPI, paste the CPT codes you bill or start from your specialty’s typical codes, and pick the payers you contract with: 66 to choose from. The codes we price →
- 02
Columns fill in as each payer is read
Save, and the sheet appears straight away. Each payer’s column fills as its file is read, fast payers in seconds and the largest in a minute or two, and you can keep working while it does. We email you when it’s ready.
- 03
Open any rate to see what’s behind it
Under each figure: how it’s priced, the network, the setting, the month of the file and a link to the file. A cell reads “not in this payer’s file” when there’s no rate for you there, never a made-up number.
- 04
Keep it current, and take it with you
Every payer is re-read on the 1st of each month, and you can refresh any time. A rate that moved shows the change. Pin the schedule you use most, fit the columns to your screen, and download it as a CSV for your biller.
What you get
Your payers, side by side.
The same visit can pay noticeably differently from one payer to the next. Seeing them together is usually the first time a practice knows which contracts are carrying it.
| Code | Service | Payer A | Payer B | Payer C | Payer D |
|---|---|---|---|---|---|
| 99213 | Office visit, established, 20–29 min | $92.10 | $104.86 | $88.40 | $97.25 |
| 99214 | Office visit, established, 30–39 min | $128.40 | $137.16 | $121.00– $131.50 | $134.80 |
| 99215 | Office visit, established, 40–54 min | $171.90 | $186.20 | $163.75 | $181.05 Est. |
| 99396 | Preventive visit, 40–64 | $171.25 | $190.00 | Not in file | $176.60 |
| 96127 | Brief emotional/behavioral assessment | $5.12 | $4.85 | $5.40 | Not in file |
A range is where a payer publishes more than one office rate for your practice and its file doesn’t say which applies. “Est.” is a rate the file itself marks “derived”. “Not in file” means the payer’s file has no rate for this code under your NPI. In the app, every figure opens to its network, setting, file month and source file.
Going through your payers before a renewal? Download the free fee schedule checklist →
Then
A fee schedule is where the other two start.
Upload your allowed amounts by code and see which codes a payer allowed below the rate on your fee schedule, the claims affected and the dollar gap. Totals only, no patient data. →
Rate monitoringEvery payer on your fee schedule is re-read on the 1st of each month, and you get an email when a rate moved: the code, the payer, was, now and the change. →
Questions
Fee schedules, answered.
What is a provider fee schedule?
The list of what a payer has agreed to pay a provider for each CPT code: your contracted rates with that payer. Every payer you take has its own, and an insurance fee schedule from one payer says nothing about another. RateBench puts them side by side.
Where do the rates come from?
From the files commercial payers are required to publish under the federal Transparency in Coverage rule: the in-network rates they have agreed with each provider, listed by NPI and tax ID and republished every month. For Medicare, the amount in its own physician fee schedule for your pricing area.
Is this the same as my contract?
It is the rate the payer published for your practice, which is the payer’s own statement of what it agreed to pay you. If your contract was amended after the file was published, the change shows in a later month’s file. Where you have the contract to hand, it’s worth comparing; where you don’t, this is usually the fastest way to see your rates at all.
What if a payer doesn’t list my NPI?
Many contracts sit at the group level. Add your tax ID and only rates under your practice count, or build the schedule on your group (organization) NPI. If a payer still has no rate for a code, the cell says “not in this payer’s file” rather than showing a number we don’t have.
Which payers do you read?
66 today: the local Blue plan in 49 states and DC, plus UnitedHealthcare, Aetna, Cigna, Ambetter, Oscar and Medicare. Medicaid and Medicare Advantage rates aren’t published in these files, so they aren’t included.
How current is it?
Payers republish monthly. We re-read every payer on your fee schedule on the 1st of each month, and you can refresh a schedule any time to re-read it straight away. Any rate that moved is shown with the change.
Can I export it?
Yes, as a CSV: your CPT codes down the first column, one column per payer, the rate in each cell. It opens in Excel or Google Sheets, so your biller can compare it against what’s in your practice management system.
What does it cost?
The Practice plan is $99 a month for one location and two specialties, with underpayment checks and rate monitoring included and unlimited teammates. Cancel anytime. You can look up your rates free first: 2 lookups a month with no account, 10 a month with a free account.
See your rates side by side.
The Practice plan is $99 a month for one location and two specialties, with underpayment checks and rate monitoring included. Cancel anytime.
Not ready? Look up one rate free or see the payers we read.