Built on federal price-transparency data · Pediatrics
Benchmark the well-child, vaccine, and visit codes that carry your practice.
Pediatric revenue runs through well-child visits, immunization administration, and office E/M — and the commercial side of that book is negotiable. EarnestMD benchmarks your contracted rates on those codes against comparable pediatric practices on the same payers, so you can see where your commercial contracts actually stand.
The problem
Pediatrics carries a distinctive code mix — preventive well-child visits, immunization administration codes, and sick-visit E/M — and the commercial portion of your panel is where rate gaps live. The payer knows the market rate for the vaccine-admin and well-child codes you bill all day; you see your own schedule. On immunization administration especially, where margins are thin and volume is high, a per-code gap compounds quickly.
- A code mix surveys handle poorly. Well-child and immunization-admin codes are central to pediatrics and rarely benchmarked against named payers.
- Thin-margin, high-volume vaccine codes. Small admin-fee gaps add up across a busy schedule.
- Commercial vs. public mix. The transparency files cover commercial payers; that's exactly the negotiable slice of your panel to focus on.
What you get
- Pediatric code benchmarking by payer. Well-child, immunization administration, and office E/M codes set against comparable pediatric practices across the major commercial payers.
- Dollar impact by volume. Per-code gap × your annual volume = recoverable dollars, ranked — with the high-frequency vaccine and well-child codes surfaced.
- Commercial-focused view. Benchmarks on the commercial contracts you can actually move.
- Internal + payer-ready report pair. Strategy stays confidential; the payer gets a sanitized, sourced case.
Procedures we benchmark
- CPT 99392
- CPT 99393
- CPT 90460
- CPT 90471
- CPT 99213
In practice
Same engine, pediatric code set: well-child, immunization administration, and sick-visit E/M, by named payer, against comparable practices.
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.
Pediatrics FAQ
- Do you benchmark immunization administration codes?
- Yes — the vaccine-admin and well-child codes central to pediatrics are part of the benchmark, alongside office E/M.
- What about Medicaid / public payers?
- The federal transparency files cover commercial payers, so the benchmark focuses on your commercial contracts — the negotiable part of the book.
- Do you need our 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 pediatrics payer gaps in minutes — the live demo needs no account.
Other specialties
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.