Glossary

The middle rate. Half the published rates sit above it and half below.

The median is harder to distort than an average, because one unusually high or low contract cannot pull it far.

The rate that appears more often than any other.

When many contracts land on the same figure, that figure is often a payer's standard offer. The mode is where you are most likely to start from.

The highest published rate after outliers are removed. No percentile is involved.

It is a real rate that at least one provider is paid. It is at the top of the range, so it is a number to argue toward, not a number to expect.

Where a rate sits against every other published rate. At the 48th percentile, 48 percent of published rates are lower than yours.

A low percentile does not automatically mean you are underpaid, and a high one does not mean you are done. It tells you where the conversation starts.

How many published rates the figures in that row are based on.

More rates make the figures steadier. A row built on a handful of rates can move a lot when the next data cut arrives.

There were not enough published rates here to report a reliable figure, so we withhold it instead of estimating.

An empty cell here is deliberate. Showing a number built on two or three contracts would look like market intelligence without being any.

How intensive the treatment is — for example inpatient, residential, partial hospitalization, or intensive outpatient.

Rates are grouped by level of care because that is the unit payers contract on. Comparing across levels compares different products.

A number from the American Society of Addiction Medicine that names a level of addiction treatment, such as 3.5 for residential.

Addiction treatment levels of care follow the ASAM system, so we tag them with the ASAM number. Mental health levels of care have no ASAM equivalent and carry no tag.

One negotiated amount for a qualifying day of care, rather than a price per service.

A per-diem rate often bundles several services into the daily amount. Exactly which ones varies by payer and contract.

This billing code is used for both addiction treatment and mental health care, so it is not specific to one of them.

A shared code appears in both service lines. The rate attached to it is the same rate, whichever service line you reach it from.

Published rates for this code are spread far apart, so a single number does not describe the market well.

Treat a high-variability code as a range rather than a going rate. The spread usually means payers are buying different things under the same code, or that a few contracts sit far from the rest.

MAC is short for Medicare Administrative Contractor, the regional company that processes Medicare claims. Pricing for this code differs from region to region.

We flag the code because the regional difference makes a national figure misleading. Whether a commercial payer follows the same regional pattern depends on the contract.