Module 01
ReimburseOS · Rate intelligence
Predicts contracted rates from every payer's TiC machine-readable file. Surfaces every CPT code where you're paid below market.
Powered by ReimburseOS data
100,000+ rate combinations
Predict expected payment
Live toolExpected payment
$94.20
From Anthem CA TiC MRF · 2026-04-01
MGMA percentile
p64
National median $87.40
Confidence
High · 94%
12,418 contract observations
Source MRF row
anthem_ca_2026-04-01.json.gz
billing_code 98941 · negotiated $94.20
billing_code 98941 · negotiated $94.20
Predicted annual revenue
$2,418,540
↑ $124K vs 2025
Underpaid CPT codes
10
4 below p25
Total annual gap
$187,420
vs market p50
Active payers tracked
10
CA, NY, TX coverage
Top 10 underpaid CPT codes
CPT
Description
Your rate
p25
p50
p95
Action
97110
Therapeutic exercise · 15 min
Anthem CA · highest volume
$67.40
$72.80
$94.20
$112.50
97140
Manual therapy · 15 min
Aetna · 28% of paid below p25
$52.10
$58.40
$78.90
$98.20
97530
Therapeutic activities · 15 min
UHC · plan-of-care driven
$71.20
$74.50
$98.40
$118.10
97112
Neuromuscular re-ed · 15 min
Blue Shield CA · vestibular
$74.80
$78.00
$102.30
$124.60
97162
PT eval · moderate complexity
Cigna · plan-of-care attached
$108.40
$112.20
$148.30
$181.40
97161
PT eval · low complexity
Humana · low volume
$92.10
$98.40
$128.90
$156.20
97163
PT eval · high complexity
Kaiser · post-surgical
$132.40
$138.90
$184.20
$224.50
97164
PT re-eval · established
Anthem CA · q90d
$58.20
$62.40
$84.60
$104.20
97035
Ultrasound therapy · 15 min
BCBS-TX · adjunctive modality
$22.40
$24.80
$31.20
$38.40
97014
E-stim · unattended
Centene · denial-prone
$14.80
$16.20
$22.40
$28.80
Selected · CPT 97110 · Anthem CA
Rate distribution across the market
Your contracted rate$67.40
Market p25$72.80
Market p50 (median)$94.20
Market p75$104.10
Market p95$112.50
Annualized gap to p50
$48,200
~1,800 units of 97110 per year at $26.80 below median
Payer mix · 2026 YTD
Predicted revenue by payer
Anthem CA$724K · 30%
Aetna$508K · 21%
UHC$432K · 18%
Blue Shield CA$362K · 15%
Cigna$216K · 9%
Kaiser · Humana · BCBS-TX · others$176K · 7%