PMI has developed exclusive data for Pediatric practices to better understand the negotiated rates between payers and individual practices. Now you can subscribe to the available data to see how your negotiated rates with payers compare with other practices in your community. Check out what PMI provides to help you better manage your negotiated rates with payers.
99213: Based on 1,859 records: - The median negotiated rate is $114.83 - The mean rate is $117.71 - Rates range from $31.59 to $457.09 - The standard deviation is $46.52 - 25% of rates are below $77.71 - 75% of rates are below $150.28 - The interquartile range (IQR) is $72.57
How Do You Stack Up?
Grab your most recent EoB from your billing department and see how you stack up. If your current rates are below the median value shown above, you might need to consider identifying opportunities to improve your rates. You can also utilize PMI's PayerIntel subscription to educate yourself on how much payers in your area are paying for the top 30 CPT codes.
Most practices usually postpone data analysis and rate negotiations until contract renewal. However, with access to crucial data from PayerIntel, you should consider renegotiating whenever the data reveals a discrepancy affecting your practice’s financial health.
