How the numbers are made

Every figure is a published distribution with its sample attached. Ontology lists and payer-file discovery methods stay private.

Distributions, never advice. Behavioral Rates shows p25 / median / p75 of publicly disclosed in-network rates with the sample size behind every number. It never suggests, ranks, or endorses a rate, a payer, or a negotiation target.

Sources and cadence

The product classifies public files. It does not invent a rate.

Primary source: Public CMS Transparency-in-Coverage in-network machine-readable files published monthly by commercial health plans.
Facilities: Facility identity and class come from the NPI registry (NPPES). Facilities are keyed by NPI.
Scope: Commercial in-network negotiated rates for behavioral-health facility services. Medicaid managed care and Medicare Advantage have no TiC obligation and are out of scope.
Refresh: Monthly. Each snapshot is a point-in-time pull; history cannot be backfilled. Not every payer book refreshes every month.
In-network and out-of-network: These are separate products: separate tables, routes, entitlements, and visuals. They are never joined.

Services stay separate

A detox day and an IOP day are different products. They never share a median.

Detoxification: Medically managed or monitored withdrawal management in an inpatient or residential setting.
Residential Treatment — Substance Use: 24-hour residential treatment for substance use disorders (non-hospital).
Residential Treatment — Mental Health: 24-hour residential psychiatric treatment (non-hospital).
Partial Hospitalization (PHP): Structured day treatment, typically 5+ hours per day, several days per week; the patient does not stay overnight.
Intensive Outpatient (IOP): Structured outpatient programming, typically 3 hours per day, several days per week.

Facility classes

Each class keeps its own distribution. They are never averaged.

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

The sample rides on every number

A figure from two facilities is visibly weaker than one from forty.

Every published cell states how many distinct facilities and payer books stand behind it. A cell built from fewer than 3 facilities is labeled as a small sample and de-emphasized. Counts are per row and are never summed across rows.

Caveats stay in English

Flags are not hover-only. The short label is what you see; the sentence is what it means.

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
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, a facility, and a print view.

Explore the product Known issues