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Built on federal price-transparency data · Urgent Care

High volume means small gaps add up fast.

Urgent care runs on throughput — a tight set of E/M and procedure codes billed thousands of times a year across multiple payers. At that volume, a few dollars of gap per visit is real money. EarnestMD benchmarks your contracted rates on those codes against comparable centers on the same payers and ranks every gap by what it's worth annually.

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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

Your margin is a volume game, which means rate gaps compound. The payer knows what every urgent care operator in the market is paid for the visit codes (and the S9083/global arrangements where they apply) that make up your day. You see your own contracts across several payers and can't tell which one is the laggard — and on a high-throughput book, the laggard is expensive.

  • ✓Volume amplifies every gap. A small per-visit shortfall across thousands of visits is a material annual number.
  • ✓Multi-payer blindness. You can't see which of your payers trails on your core codes without a cross-payer benchmark.
  • ✓Global/per-case arrangements obscure comparison. Where payers use case-rate or global structures, apples-to-apples comparison is hard without clean data.

What you get

  • ✓Visit + procedure benchmarking by payer. Your highest-volume codes set against comparable centers across the major commercial payers.
  • ✓Recoverable-dollars ranking. Every code ranked by annual recoverable dollars on your volume — biggest levers first.
  • ✓Multi-site view. Benchmarks across locations where your footprint spans markets.
  • ✓Payer-ready proposal. A sanitized, sourced market-position document per payer.

Procedures we benchmark

  • CPT 99203
  • CPT 99204
  • CPT 99213
  • CPT 99214
  • CPT S9083

In practice

Same engine, urgent-care code set: high-volume visit and procedure codes, by named payer, against comparable centers.

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.

Urgent Care FAQ

Do you handle case-rate or global arrangements?
Our benchmark is built on the line-item CPT/HCPCS rates payers publish. Where a payer uses a case-rate or global structure for a visit, that line isn't directly comparable — so we focus on the codes that are, and flag where a global rate limits the comparison.
Can you compare across our locations?
Yes — multi-site is supported; you give us the NPIs.
How fast can we see something?
Minutes — the demo needs no account.

Find out what you’re leaving on the table.

Open the workbench and see your urgent 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
  • Primary 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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  • Anesthesiology
  • Interventional Spine
  • Ophthalmology
  • Hospital Medicine
  • Urgent Care
  • Primary Care
  • Pediatrics

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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.