Which files are the figures built from?

Public CMS Transparency-in-Coverage machine-readable files — payers' in-network rate files and out-of-network allowed-amount files — refreshed monthly, joined to the NPPES registry for facility identity and type.

Why are services never averaged?

A detox day and an IOP day are different products. Each level of care keeps its own definition and published range so a blended figure cannot form.

Are in-network and out-of-network combined?

No. They are separate products: separate tables, routes, entitlements, and visuals. They are never joined into one number.

How current is a snapshot?

Each snapshot is a point-in-time monthly pull. Not every payer updates monthly; significant moves are flagged. The data month travels with the figure.

How the numbers are made

Every number comes from a file an insurer published, and every number shows how many payers and facilities it is based on.

Ranges, never advice. Behavioral Rates shows the low end, typical and high end of what payers publish, with the number of facilities behind every figure. It never suggests, ranks, or endorses a rate, a payer, or a negotiation target.

Where the data comes from

We sort and label what insurers publish. We never make up a rate.

Primary source: The in-network rate files every commercial health plan must publish each month under the federal Transparency in Coverage rule.
Facilities: Each facility is identified by its NPI (its federal provider number). Its facility type comes from the national provider registry.
Scope: Commercial in-network contracted rates for behavioral-health facility care. Medicaid managed care and Medicare Advantage plans are not required to publish, so they are not here.
Refresh: Monthly. Each snapshot is a point-in-time pull. Not every payer updates monthly; significant moves are flagged.
In-network and out-of-network: These are separate products built from separate files. We never mix the two.

Out-of-network.

Out-of-network figures come from a different federal file than in-network rates: the allowed-amount file each payer publishes monthly. It lists, for each facility and billing code, the amount the plan allowed and the amount the facility billed, aggregated over a 90-day window that ends roughly six months before publication.

Two things make this data thin by construction. First, federal rules require a payer to suppress any facility-and-service combination with fewer than 20 claims in the window, and out-of-network facility care rarely reaches that count. Second, most payers publish one file for all their plans, so a figure usually blends fully-insured, self-funded and marketplace business. Where a payer publishes separate plan files, we show them by name. Where it does not, we infer the plan type from the identifiers in the file header and label the figure as inferred.

Many self-funded employer plans do not price out-of-network claims themselves. They route the claim through a repricer, most often a MultiPlan program or Imagine360, and the repricer's schedule is what the facility is paid. We load those schedules as their own sources, attribute them to the repricer, and never to the insurer whose file linked to them.

Charges are the facility's own billed amounts as they appear in payers' files. A facility bills the same charge to every payer, so charges are the most complete facility-level figure we have. We show what comparable facilities bill; we do not suggest a charge.

Allowed is not paid. The allowed amount is what the plan recognized before the patient's share. Every out-of-network figure on this site is a published range with its sample size. None of it is advice on what to charge, what to accept, or whom to admit.

Levels of care are never mixed

A detox day and an IOP day are priced separately. We never blend them into one number.

Detoxification: Medically supervised withdrawal from alcohol or drugs, with an overnight stay. Billed per day.
Residential Treatment — Substance Use: Live-in treatment for drug or alcohol addiction at a non-hospital facility. Billed per day.
Residential Treatment — Mental Health: Live-in treatment for a mental health condition at a non-hospital facility. Billed per day.
Partial Hospitalization (PHP): Day treatment, usually five or more hours a day, several days a week; the patient goes home at night.
Intensive Outpatient (IOP): Outpatient treatment, usually about three hours a day, several days a week.

Facility types

Each facility type is shown on its own. We never average a hospital unit with a freestanding center.

BH_CLINIC

Behavioral Health Clinic

SUD_RESIDENTIAL

Residential SUD Facility

PSYCH_RTC

Psychiatric Residential (RTC)

SUD_UNIT

Hospital SUD Unit

PSYCH_HOSPITAL

Psychiatric Hospital

SUD_OTP

Opioid Treatment Program

Every number shows what it is based on

A number from two facilities looks different from one from forty.

Every figure states how many facilities and how many payers stand behind it. A figure built from fewer than 3 facilities is labeled a small sample and shown in a lighter style. The counts belong to that one figure and are never added up across figures.

Warnings are written in plain words

Every warning has a short label and a sentence that says what it means. Nothing is hidden behind a hover.

Small sample: Small sample — based on fewer than 3 facilities
National contract: National contract — payer has no home-state presence here; the rate may be rented-network paper
Repeated rate pattern: Repeated rate pattern — rates in this book repeat across facilities and may reflect a template, not negotiation
Coverage varies by payer: Coverage varies by payer — not every payer refreshed this month
One payer dominates: One payer contributes most of the observations behind this number; treat the spread as that payer's book more than a market.
Different facility mix: Different facility mix — these services sample different facility types; compare within a type
Newer data expected: Newer data expected — a more recent month should replace this snapshot
Known issue: Known issue — a confirmed data problem affects this result

Open the product to see these rules applied to a state and a facility.

See the product Known issues

How a range reads

Every range on the site is drawn the same way.

The shaded band is the middle range of published rates (25th to 75th percentile). The dark tick is the typical (median) rate. Each facility type has its own typical rate. These two examples show the shape only.

State middle range (25th–75th)
State median

Questions

Which files are the figures built from?: Public CMS Transparency-in-Coverage machine-readable files — payers' in-network rate files and out-of-network allowed-amount files — refreshed monthly, joined to the NPPES registry for facility identity and type.
Why are services never averaged?: A detox day and an IOP day are different products. Each level of care keeps its own definition and published range so a blended figure cannot form.
Are in-network and out-of-network combined?: No. They are separate products: separate tables, routes, entitlements, and visuals. They are never joined into one number.
How current is a snapshot?: Each snapshot is a point-in-time monthly pull. Not every payer updates monthly; significant moves are flagged. The data month travels with the figure.