CPT 90837, the 60-minute therapy hour. Behavioral health spent decades being paid less than comparable medical visits while parity law sat on the books with no way for a clinician to check. Since July 2022, federal Transparency in Coverage rules put every major payer's contracted rates in public, machine-readable files, refreshed monthly. The gap parity was supposed to close is finally something you can look up.
Every few years, Congress moved parity forward. The missing piece was never the law. It was the data: nobody outside the payer could see the actual contracted rates being compared. That changed in 2022, and it is why parity is now rate leverage instead of a slogan.
The first federal parity law bans unequal annual and lifetime dollar limits on mental health benefits. A start, with loopholes you could drive a fee schedule through.
The Mental Health Parity and Addiction Equity Act extends parity to financial requirements and treatment limitations. Mental health and substance use benefits cannot be managed more restrictively than comparable medical or surgical benefits.
Parity reaches individual and small-group plans, and mental health and substance use treatment become essential health benefits.
Plans must produce comparative analyses of their non-quantitative treatment limitations on request from regulators. How a plan sets provider reimbursement is among the limitations federal guidance has told plans to analyze.
Starting July 2022, payers publish their negotiated rates in machine-readable files: every code, every contracted clinician, refreshed monthly. The comparison parity always implied becomes public record.
For the first time, a solo therapy practice can read the same rate table the payer reads. That is what turns a parity promise into rate leverage at renewal time.
Milliman's landmark disparity analysis compared what commercial PPO plans paid for the same office-visit codes, behavioral versus medical, relative to Medicare-allowed amounts.
Index basis: percent of Medicare-allowed amounts for identical office-visit codes, behavioral indexed to 100. Primary care was reimbursed 23.8 percent higher. Source: Milliman research report, Addiction and mental health vs. physical health, 2019, analyzing 2017 commercial PPO claims.
How much more likely an office visit with a behavioral health clinician was to be out-of-network than one with a medical or surgical provider, in the same analysis.
Out-of-network utilization is what underpayment looks like from the patient's side: when the in-network rate cannot hold a practice, the practice leaves the network. That is a rate problem. And now that the rates are public, a rate problem is something you can document, payer by payer, code by code. It is exactly the comparison federal parity guidance tells plans to take seriously.
The difference between a 45-minute rate and a 60-minute rate, multiplied across a caseload and a year, is the quietest number in your practice. Every payer files both.
The session the system nudges you toward. CPT's time rule places it at 38 to 52 minutes with the patient. For many caseloads it is the default visit, which makes its contracted rate the default economics of the practice.
The full clinical hour. Some national payers have pressured clinicians over billing it routinely, which makes knowing your contracted rate for it, and your peers' filed range, the difference between defending your documentation and doubting it.
Same chair. Same clinician. Same payer. Two filed rates. The spread between 90834 and 90837 varies payer to payer in the same city, and so does the rate each payer files for the identical code. The spread is where renewal conversations start, and the free Snapshot is where you see yours.
Look up both rates free →Illustrative arithmetic, in the open. Drag the sliders. Your real numbers come from your filed rates and your real volume, and the free Snapshot is where you see those.
A calculator, not a claim about your practice. Assumes 46 working weeks. Real per-code, per-payer numbers come from the public filings.
A Snapshot replaces the hypothetical with the rates your payers actually filed. Where a gap is real, it becomes documented reimbursement opportunity, an estimate grounded in public data, never a guaranteed outcome.
One flat-fee report that puts your filed psychotherapy rates next to the medical context parity law says they should be compared against. Nothing is for sale on this page today. Joining the waitlist costs nothing and reserves founding access.
Flat-fee parity benchmarking for behavioral health, built entirely from public federal filings. No PHI, ever.
Founding members get first access when the Parity Gap Report opens in Q3 2026. While you wait, the free Practice Snapshot is live today, about 15 seconds, no PHI.
Run a free SnapshotReddenda documents benchmarks and documented reimbursement opportunity from public federal filings. It is not a law firm, the Parity Gap Report is not legal advice, and documentation does not guarantee any payer response, parity determination, or negotiation outcome.
The core Reddenda platform is open to behavioral health right now.
A payer-ready negotiation memo for a single renewal.
See pricing →Full-practice review: every code, every payer, one strategy.
See pricing →Your payers already filed their rates for 90837 and 90834 in public federal data. Reading them is free.