Built on federal price-transparency data · Hospital Medicine
Benchmark the E/M codes your group lives on.
Hospital medicine revenue runs through a tight set of inpatient E/M codes — admissions, subsequent care, discharges — and the commercial portion of that book is negotiable. EarnestMD benchmarks your contracted rates on those codes against comparable hospitalist groups on the same payers, so your next contract (or subsidy) conversation runs on data, not assertion.
The problem
Hospitalist economics get framed as “the hospital covers the gap,” which buries a real question: are your commercial E/M rates actually competitive? The payer knows what every hospitalist group in the market is paid for 99223, 99232, 99238 and the rest. You see your own schedule and a stipend negotiation where the other side holds the rate data. Without a benchmark, you can't tell whether the contract — or the subsidy that backfills it — is sized to the market.
- The core codes go unexamined. A handful of inpatient E/M codes drive the book, and they're rarely benchmarked against named payers.
- Subsidy talks run blind. Hard to argue the gap to the hospital without showing where your commercial rates actually sit versus peers.
- Blended medians miss it. National survey averages won't tell you your rate on a specific payer for a specific level of care.
What you get
- Inpatient E/M benchmarking by payer. Your admission, subsequent-care, and discharge codes set against comparable hospitalist groups on UHC, BCBS, Aetna, and Cigna.
- Dollar impact by encounter volume. The per-code gap × your annual volume = the recoverable amount, per payer.
- Subsidy-conversation ammunition. A defensible read on where your commercial rates lag — useful with both the payer and the hospital.
- Internal + payer-ready report pair. Strategy stays confidential; the payer gets a sanitized, sourced case.
Procedures we benchmark
- CPT 99223
- CPT 99232
- CPT 99233
- CPT 99238
- CPT 99291
In practice
The same engine that benchmarks anesthesia and ophthalmology runs on inpatient E/M — your core codes, by named payer, against comparable hospitalist groups.
How it works
- 1. Tell us your practice — NPIs (or group name) + the payers and codes that matter. No claims data, no contracts.
- 2. We resolve your rates — match your providers and comparable peers to payers’ federally-required published rates.
- 3. Open the workbench — your rates, benchmarked by payer, code, and site of service; every gap in dollars.
- 4. Build your ask — rank by recoverable dollars; print a board-ready report and a sanitized payer-facing proposal.
Hospital Medicine FAQ
- Does this work if we're hospital-affiliated?
- If your group negotiates its own commercial contracts, yes — we benchmark those rates. If rates are fully set by an employer, the value is mainly in the subsidy/market case.
- Which codes do you cover?
- The inpatient E/M set that drives hospitalist revenue, plus any others you bill. You tell us what matters.
- Do you need claims data?
- No — NPIs (or group name) and your payers.
Find out what you’re leaving on the table.
Open the workbench and see your hospital medicine payer gaps in minutes — the live demo needs no account.
Rate figures are derived from payers’ public price-transparency filings published under the Transparency in Coverage rule. EarnestMD is independent and not affiliated with any insurer.