Pulse Medical

Pricing Options

Get instant access to the latest negotiated rates for any provider.

Monthly
Yearly

Snapshot Reports

Starting at

$100

per payer

Point-in-time snapshot of negotiated rates for up to 10 codes

Detailed provider data for up to 10 NPIs with published rates

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Purchase

Specialty Subscription

Starting at

$75

per payer per month

(Annual contract required)

On-going access to the latest negotiated rates for up to 10 codes

Ability to browse detailed provider data for any NPI

Network relationship data between practices and providers

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Access to data analysis team to assist with any complex reporting needs

API access available

Request a Quote

Full Subscription

Starting at

$500

per payer per month

(Annual contract required)

On-going access to the latest negotiated rates for up to 250 codes

Ability to browse detailed provider data for any NPI

Network relationship data between practices and providers

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Access to data analysis team to assist with any complex reporting needs

API access available

Request a Quote

Snapshot Reports

Starting at

$100

per payer

Point-in-time snapshot of negotiated rates for up to 10 codes

Detailed provider data for up to 10 NPIs with published rates

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Purchase

Specialty Subscription

Starting at

$750

per payer per year

On-going access to the latest negotiated rates for up to 10 codes

Ability to browse detailed provider data for any NPI

Network relationship data between practices and providers

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Access to data analysis team to assist with any complex reporting needs

API access available

Request a Quote

Full Subscription

Starting at

$5,000

per payer per year

On-going access to the latest negotiated rates for up to 250 codes

Ability to browse detailed provider data for any NPI

Network relationship data between practices and providers

CSV download format that includes billing class, negotiated rate type, billing code modifiers, and place of service

Access to data analysis team to assist with any complex reporting needs

API access available

Request a Quote

FAQ

Questions & Answers

Answers to your most frequently asked questions.

What is the definition of a payer in Pulse Medical?

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.

Where does the negotiated rate data come from?

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.

How do I purchase a negotiated rate report and get access to Pulse Medical?

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.

What is the format of the negotiated rate reports?

Reports are delivered in CSV format through the My Downloads section of our Pulse Medical platform.

Do Pulse Medical reports factor in Code Modifiers?

Yes, the data is split out by code and modifier combinations for every NPI with a published rate.

Do Pulse Medical reports factor in Place of Service (POS)?

Yes, rates are organized by place of service.

Can I license all available data for a specific payer on an on-going basis?

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.

Are Custom Subscription Plans Available?

Yes. Please request a quote to build a custom subscription to meet your data needs.

Can I access the data using an API?

Yes, API access is available.

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