Six service lines. Every payer. One honest ledger.
Therapy hours, TMS, Spravato, neurofeedback, IOP and PHP do not price the same way, so this surface never presents them the same way. Per-session codes carry a Medicare locality benchmark. Facility per-diems carry payer-filed rates only. Per-mg units stay per-mg. Every number traces to the CMS fee schedule or a federal filing, and every gap says so.
Live market preview: Real national benchmark rates for the behavioral health code set. Full analysis unlocks with a paid plan, flat fee, never a percentage of recovery. All payer rates from federal TiC filings.
Methodology.
Benchmark = (work RVU × GPCI work + PE RVU × GPCI pe + MP RVU × GPCI mp) × CF, the CMS Physician Fee Schedule formula with 2026 Geographic Practice Cost Indices, then multiplied by your selected target.
Facility per-diems (H0015, S9480, H0035) are not on the PFS: no benchmark is computed and they are never blended with per-session codes in any average, score, or uplift.
S0013 (Spravato) is billed in per-mg units, typically 56 or 84 mg per session, pairing with 99415/99416 observation time.
Where a payer policy excludes coverage, no documented reimbursement opportunity exists under that policy.
Full methodology →
| Code ▼ | Payer | Class | N rates | Medicare | P10 | P25 | P50 (median) | P75 | P90 | Annual Uplift | Exhibit | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Loading the behavioral health code set…Payer-filed rates load by service line: therapy and eval, TMS, Spravato, neurofeedback, IOP, PHP. | ||||||||||||
Behavioral health rate data, PHI-free, all from federal TiC filings. Each row sources from a payer's published Transparency-in-Coverage machine-readable file under 45 CFR Part 180. No estimation: every rate carries its source quarter and sample size, and per-diem rows are never blended with per-session rows in any figure. Read the full methodology →