What you are actually paid, vs what peers actually get.
Contracted rates are not what lands in the bank. Specula puts every real lens on each code side by side: your published rate, the local-peer median and P90 target, the Medicare-allowed floor, the CMS national reference, your measured paid from your own 835s, and what peers actually collect across the network. Local-peer, never national. Modeled, never a guarantee.
That's a sample BH group. Drop your NPI to surface the exact parity gaps — your BH codes vs the local-peer median and their medical equivalents — to take into your next rate renegotiation. No PHI, no card.
| Code | Band | Contracted | Peer p50 | P90 | Medicare | Nat ref | Your paid | Network | $ left |
|---|---|---|---|---|---|---|---|---|---|
90837PublishedTop gap Psychotherapy, 60 minutes | $140.00 | $152.60 | PROp75 | $141.90 | — | 835s | n<11 | $226,800 | |
90834Published Psychotherapy, 45 minutes | $112.00 | $122.40 | PROp75 | $113.70 | — | 835s | n<11 | $147,000 | |
90791Published Psychiatric diagnostic evaluation | $178.00 | $198.00 | PROp75 | $184.60 | — | 835s | n<11 | $74,520 | |
99214Published Med management, established, moderate | $142.00 | $158.00 | PROp75 | $109.00 | — | 835s | n<11 | $49,400 | |
90832Published Psychotherapy, 30 minutes | $70.50 | $78.00 | PROp75 | $72.40 | — | 835s | n<11 | $48,600 | |
99213Published Med management, established, low | $100.00 | $112.00 | PROp75 | $76.00 | — | 835s | n<11 | $46,200 | |
90847Published Family psychotherapy, w/ patient | $124.00 | $138.20 | PROp75 | $128.10 | — | 835s | n<11 | $34,500 | |
90853Published Group psychotherapy | $33.00 | $37.90 | PROp75 | $33.60 | — | 835s | n<11 | $28,800 | |
90846Published Family psychotherapy, w/o patient | $119.00 | $132.00 | PROp75 | $122.50 | — | 835s | n<11 | $20,580 | |
90838Published Psychotherapy 60 min, w/ E&M add-on | $86.00 | $96.00 | PROp75 | $88.60 | — | 835s | n<11 | $19,200 |
Peer p50 and P90 are your LOCAL-peer benchmark (never national). Where no real local P90 is indexed for a code, the target falls back to your local p75 or local median and the cell is tagged with what it actually is — we never label a median “P90”. Nat ref is the CMS national per-code reference, shown separately and never as your peer median. Your paid = your own de-identified 835 median (n≥11, no PHI); Network = cross-practice paid median where n≥11 (anonymized aggregate). Dollars left = per-unit gap to that target on your real volume: documented opportunity, modeled, never guaranteed. Where we have no volume for a code we show the documented per-unit gap and ask you for the count. A dash means we hold no value, not a value of zero — we never print a $0.00 to stand in for a number we do not have, and a code with no Medicare allowed amount (labs, drugs, most DMEPOS) reads as a dash, never as “Medicare pays $0.00”.