Pulse Medical
Pricing Options
Get instant access to the latest negotiated rates for any provider.
Snapshot Reports
Starting at
$100
per payer
Most Popular
BUCA State Subscription
Starting at
$300
per code per state
FAQ
Questions & Answers
Answers to your most frequently asked questions.
Payers are generally a combination of an insurance company (like Anthem / Blue Cross Blue Shield, Aetna, Cigna, or United Healthcare) and state. Some payers also publish rates that span multiple states.
Payers are mandated by law to publish all negotiated rates as part of the Transparency in Coverage (TiC) Rule that was passed in 2020 and went into enforcement in July of 2022.
We ingest the data that is published in the Machine Readable Files (MRFs) that are required to be updated monthly by payers in our Pulse Medical data science platform. Through Pulse Medical, we make it possible for our clients to download the negotiated rate data in Excel-friendly CSV files so they can be used as a high-quality input for contract negotiation, Revenue Cycle Management (RCM) processes, and prospecting / ROI calculation tools for healthcare-focused sales teams.
The first step is to gather the list of provider NPIs, the reimbursement codes you’d like to retrieve negotiated rates for, and (optionally) any relevant Tax Identification Numbers (TINs) or Employer Identification Numbers (EINs) that may be related to your target practices or health systems.
If you know the exact data you’re looking for, you can purchase a point-in-time snapshot report of negotiated rates for $100 per payer for up to 10 NPIs and 10 codes through our self-service order form.
If you’re not 100% certain which NPIs or EINs hold the negotiated rates published for each of your payers of interest, you can request a quote or schedule a demo to work with a knowledgeable human to help you compile your list.
Your final report will be delivered through the Pulse Medical platform.
Reports are delivered in CSV format through the My Downloads section of our Pulse Medical platform.
Yes, the data is split out by code and modifier combinations for every NPI with a published rate.
Yes, rates are organized by place of service.
Yes. Full payer licenses with access to all rates for 250 codes start at $5,000 per year (depending on the volume of your specific data needs). Partial payer subscriptions are also available for a subset of codes, starting at $750 per year for up to 10 codes.
Yes. Please request a quote to build a custom subscription to meet your data needs.
Yes, API access is available.
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