Payer detail

Every plan we bill, by state

Sample Commercial Plan C · Pennsylvania

Rate amendment pending

Allowed amount per visit by CPT code
Code	Service	Rate	Last term	Change
90791	Intake assessmentLast term $163	$167	$163	Up +3%
90832	30-minute therapyLast term $82	$84	$82	Up +3%
90834	45-minute therapyLast term $120	$124	$120	Up +3%
90837	60-minute therapyLast term $164	$169	$164	Up +3%
99204	New patient medication visitLast term $201	$207	$201	Up +3%
99214	Medication follow-upLast term $134	$138	$134	Up +3%
90833	Therapy add-on with medication visitLast term $74	$76	$74	Up +3%

Checked at every bookingDone automatically

Auth for 60-min therapy after 12 visits
Detected automatically at booking. A request is drafted from the intake and notes.
No auth for intake, 30- and 45-minute therapy, or medication visits
Claims go straight out after the note is signed.
Telehealth paid the same as in-person
Place of service 10 and modifier 95 are added automatically.

Done for you

Reminder
30-day reminder sent to Dana
2 d ago
The rate amendment expires Nov 10, 2026.
Done automatically. Ran automatically — no one had to do this by hand.
WellKeel
Countersignature drafted
9 d ago
Signature page is ready for Dana. New rates start once it is signed.
Done automatically. Ran automatically — no one had to do this by hand.
Check
Rate amendment received from the plan
14 d ago
+3% across all codes. Checked against the current rates.
Done automatically. Ran automatically — no one had to do this by hand.

From this contract

0 of 1 done

Countersign the rate amendmentDue Nov 3 · Dana Ruiz
New rates start once it is signed.

Demo only: documents are samples and nothing is downloaded.

Dana Ruiz
WellKeel owner of this contract · Operations lead
Renata Ellis · Provider relations
provider-relations-c@example.com(555) 010-0212
Theo Barnes · Contracting manager
contracting-c@example.com(555) 010-0312