Explore real-time payer policy
and reimbursement trends
OpenPayer centralizes payer policies, reimbursement benchmarks, billing code intelligence, and real-time policy updates into a searchable platform built specifically for provider organizations.
Explore reimbursement resources
Search and monitor payer policies, reimbursement benchmarks, billing codes, and coverage updates in one platform.
Provider billing profiles built from CMS Medicare and Medicaid claims data by NPI.
Explore reimbursement intelligence by service line, DRG, CPT code, and billing category.
Hospital profiles with financials, payer mix, billing codes, and related policy activity.
Analyze payer-specific reimbursement trends, coverage criteria, and policy behavior.
Compare reimbursement and policy trends across states and regional markets.
Research tools
Look up billing codes, providers, payers, taxonomy codes, modifiers, and prior authorization policies.
Search CPT, HCPCS, J-codes, DRG, and dental codes by number or procedure name.
Build a reimbursement rate report across any mix of billing codes and states, comparing commercial payers against Medicare.
Pick 2-5 payers to compare market share, premium, and membership by region, all at once.
Pick 2-6 hospital facility types (or add a specific hospital) to compare facility count, revenue, net income, and Medicare/Medicaid payer mix by region, all at once.
Find hospitals and healthcare facilities by name, taxonomy, facility type, ownership, or state.
Search national health insurance payers and health plans by name and state presence.
Search NUCC taxonomy codes by code, specialty, grouping, or classification.
Search CPT modifiers by code or name — descriptions, when to use them, and payer policy context.
Search payer prior authorization policies by drug, procedure, or policy name.
Find payer timely filing policies: claim deadlines, corrected claim windows, and appeal timeframes.
Search payer coverage criteria and medical necessity requirements by drug, procedure, or payer.
Claims, prior authorization, provider services, and appeals contacts for health insurance payers.