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The MediRate Platform

MediRate's Mission

MediRate makes access to Medicaid payment data easy. Our simple intuitive platform enables quick answers to your Medicaid rate questions and easy monitoring so that you can stay on top of changes when they happen.

With over 80 million Americans enrolled, and approaching $1 trillion in annual expenditures, Medicaid is the largest government-funded health care program in the United States.

Despite the size and growth of the market, state-specific program designs and the lack of standardization and comparability in data collection present challenges for policy-setters and business interests.

How MediRate Helps You

MediRate aggregates fee schedule data for key service lines across all 50 states to enable on-demand rate look-up, trend identification and cross-state comparisons.

Payment rates are updated real-time, and are searchable by state, service line, billing code, program and date.

MediRate monitors payment rate developments by state and service line and offers daily, customizable alerts, enabling users to track potential changes as they emerge.

Key Questions We Answer

Are we being reimbursed accurately for the services we offer and populations we serve?
How do the payment rates in our market compare to those in other geographies/programs? Is there an opportunity to advocate for higher payment amounts?
How do our managed care payment rates compare to fee-for-service reimbursement?
Can we design value-based contracting models with our managed care payers to drive improved outcomes?
Are there other service lines we can offer to broaden the array of treatment options we offer to patients?
Which expansion markets may be attractive for our organization to consider, either organically or through acquisitions?
How frequently are reimbursement rates adjusted and what has been the historical trend?
When considering acquisitions, how do we assess the stability of the Target's reimbursement and are there opportunities for future growth in financially viable markets?
Service Screenshot

📊Data Aggregation

MediRate aggregates fee-for-service payment amounts by CPT/HCPCS billing code across 50 states and the District of Columbia by curating:

  • State Medicaid and related agency fee schedules
  • Provider manuals
  • Provider bulletins
  • Legislative and appropriations' documents
  • Regulatory actions
  • Other sources
Historical Screenshot

📈Payment Rate Analysis

Subscribers can:

  • Search for payment rates by:
    • Service line category
    • Billing code
    • State
    • Program
    • Date
  • Track trends by analyzing payment rates over time
  • Compare rates to payment amounts in other states and national averages
Rate Screenshot

🔍Policy Monitoring

Subscribers can:

  • Monitor real-time policy developments related to Medicaid payment rates nationally and on a state-by-state basis
  • Sign up for customizable email alerts for real-time notification of policy developments in the service lines and markets that matter to you

MediRate tracks reimbursement data for the following service lines

Service Line/Provider TypeMediRateComing Soon
Applied Behavioral Analysis (ABA) and Early Intervention (EI) Services
Home and Community Based Services including Personal Care
Behavioral Health services
Substance Use Disorder services
Services for Individuals Living with Intellectual and Developmental Disabilities
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