Resources

Negotiating higher reimbursement rates

Most practices sign the first fee schedule a payer offers — and payers count on it. But contracted rates are negotiable more often than clinicians assume, especially for specialists, undersupplied specialties like behavioral health, and practices in coverage-gap geographies.

When you have leverage

At initial contracting (before you've signed), at renewal windows, when your specialty is scarce on their panel, and when you can document rates from comparable payers. The worst time to negotiate is never — rates quietly erode against inflation every year you don't look at them.

What to actually ask for

Target your highest-volume codes, not the whole schedule; ask for percentage-of-Medicare benchmarks rather than vague increases; and get the final schedule in writing before countersigning. A few points on your top ten codes is often worth thousands per provider per year — recurring, not one-time.