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Built on federal price-transparency data · Primary Care

Your office-visit rates set the whole book — benchmark them.

Primary care revenue concentrates in office E/M and preventive-visit codes, billed at high frequency across every payer. EarnestMD benchmarks your contracted rates on those codes against comparable practices on the same payers, so you can see exactly where you sit before the next renewal — not after.

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4 national payers (UHC · BCBS · Aetna · Cigna)Billions of negotiated rates analyzedEvery site of service (office · HOPD · ASC)Minutes to a live workbench

The problem

The codes that make up the bulk of your visits — established and new-patient office E/M, preventive/wellness — are exactly the ones a stale contract quietly underpays. The payer knows the market rate for 99213, 99214, the preventive series, and more. You see your own fee schedule and renewals that roll over untouched. Without a benchmark you can't tell whether your foundational rates are competitive or years behind.

  • ✓High-frequency codes, low visibility. The everyday E/M codes drive the book and are rarely benchmarked against named payers.
  • ✓Renewals roll over. Contracts auto-renew at stale rates while the market moves.
  • ✓Surveys blend it away. National medians won't tell you your 99214 rate on a specific plan.

What you get

  • ✓Office E/M + preventive benchmarking by payer. Your core codes set against comparable practices across UHC, BCBS, Aetna, and Cigna.
  • ✓Dollar impact by visit volume. Per-code gap × annual volume = recoverable dollars, ranked.
  • ✓Renewal timing leverage. A current read on where you stand, ready before the contract conversation.
  • ✓Internal + payer-ready report pair. Confidential math stays internal; the payer gets a sourced case.

Procedures we benchmark

  • CPT 99213
  • CPT 99214
  • CPT 99204
  • CPT 99395
  • CPT 99396

In practice

Same engine, primary-care code set: office E/M and preventive visits, by named payer, against comparable practices.

How it works

  1. 1. Tell us your practice — NPIs (or group name) + the payers and codes that matter. No claims data, no contracts.
  2. 2. We resolve your rates — match your providers and comparable peers to payers’ federally-required published rates.
  3. 3. Open the workbench — your rates, benchmarked by payer, code, and site of service; every gap in dollars.
  4. 4. Build your ask — rank by recoverable dollars; print a board-ready report and a sanitized payer-facing proposal.

Primary Care FAQ

Does this account for value-based contracts?
We benchmark the fee-for-service rates payers publish; value-based/quality arrangements sit alongside that and aren't in the transparency files.
Which codes do you benchmark?
Office E/M and preventive are the core; you tell us the full set.
What do you need to start?
NPIs (or group name) and your payers. No claims data, no contracts.

Find out what you’re leaving on the table.

Open the workbench and see your primary care payer gaps in minutes — the live demo needs no account.

Open the live demoGet the Rate Gap Checklist

Other specialties

  • Anesthesiology
  • Interventional Spine
  • Ophthalmology
  • Hospital Medicine
  • Urgent Care
  • Pediatrics

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.

EarnestMD

Payer rate intelligence for provider contract negotiations. Built from public federal price-transparency filings.

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Specialties

  • Anesthesiology
  • Interventional Spine
  • Ophthalmology
  • Hospital Medicine
  • Urgent Care
  • Primary Care
  • Pediatrics

Resources

  • Rate benchmarks
  • Free rate check
  • How we compare
  • Rate Gap Checklist
  • Payer renegotiation guide

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Contact

  • info@earnestmd.com

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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.