Payer policy intelligence

Payer policy matrices, one per specialty.

State-by-state and payer-by-payer trackers of the rate, authorization and billing changes that move revenue. Every cell links to the state agency, CMS or payer document it came from. Free, no email gate. Last updated October 3, 2026.

ABA

ABA Payer Policy Matrix

State Medicaid, BCBS/Anthem, UnitedHealthcare/Optum, Aetna, Cigna/Evernorth, Humana and TRICARE changes that affect applied behavior analysis billing and authorization.

81 state changes50 jurisdictions with a change26 federal / national
50 states + DC + TRICARE · /aba-payer-matrix →
Behavioral health

Behavioral Health Payer Policy Matrix

Medicaid, Medicaid MCO, Medicare and commercial payer changes for mental health and substance use disorder services: rates, prior authorization, telehealth and credentialing rules.

83 state changes48 jurisdictions with a change13 federal / national
50 states + DC · /bh-payer-matrix →
PT / OT / Speech

PT, OT & Speech Therapy Payer Policy Matrix

Medicaid, Medicare, Blue plans, UnitedHealthcare and workers' comp changes for outpatient physical, occupational and speech therapy: visit limits, prior authorization and fee schedules.

49 state changes35 jurisdictions with a change9 federal / national
50 states + DC · /therapy-payer-matrix →
FQHC

FQHC Payer Policy Matrix

PPS and alternative payment rates, MCO wraparound, encounter billing rules, telehealth, dental and behavioral health changes for Federally Qualified Health Centers.

73 state changes38 jurisdictions with a change11 federal / national
50 states + DC · /fqhc-payer-matrix →
Emergency department

ER Payer Policy Matrix

State surprise-billing law, Medicaid ER policy, Medicaid managed care and Blue plan rules for ER professional claims, plus the Medicare contractor for every state.

184 state rules51 jurisdictions15 federal / national
50 states + DC · ER billing →

How we build these: research covers official sources only (state Medicaid bulletins and manuals, CMS and the Federal Register, state legislatures, and each payer’s own provider notices). Each cell holds the single most material change we could verify in the coverage window. A blank cell means we found no verified change, not that nothing changed, so always confirm against your own payer contracts and bulletins.