Medicare Fee
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Documented parity gaps — your BH codes vs the local-peer median and their medical equivalents — to support an MHPAEA inquiry or rate renegotiation. Documented opportunity, never guaranteed.

Medicare Fee Calculator

CMS PFS

The locality-adjusted Medicare allowed for any CPT — computed the CMS way (RVU × GPCI × conversion factor), office and facility. Then see what your local peers actually get commercially, as a percent of Medicare. No PHI.

Computing…

Medicare is the floor most commercial contracts index off. Score every code you bill against both Medicare and your local commercial peers on a discovery call to see where you have the most room. Unlock every BH code, full parity evidence vs medical equivalents, and appeal-ready leverage memos — each tier adds one more proof point for your rate inquiry.

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