Tools — Billing Codes, Providers & Payers
Look up a billing code, find a hospital, or check which payers operate in a state. These tools cover the day-to-day research billers, coders, and revenue-cycle teams do on OpenPayer, with reimbursement, coverage, and prior authorization context built in.
All of these tools draw on the same open dataset. When you want the bigger picture, you can follow every payer policy update in the live policy feed or browse the full library of CPT, HCPCS and DRG billing codes.
Not sure where to start? Try our agentic searchSearch CPT, HCPCS, J-codes, DRG, and dental codes by number or procedure name. Open any result for full descriptions, modifiers, Medicare reimbursement, and prior authorization context.
Build a reimbursement rate report across any mix of billing codes and states. Compare commercial payers against Medicare, chart it, and download as CSV, PNG, or PDF.
- Commercial vs. Medicare
- By state or by code
- CSV / PNG / PDF export
Compare hospital facility types on bed count, revenue, net income, and Medicare/Medicaid payer mix by region. Toggle regions and metrics, then chart or download the results.
Find hospitals and healthcare facilities by name, taxonomy, facility type, ownership, or state. Use it for contracting research and provider footprint analysis.
Search national health insurance payers and health plans by name and filter by state presence. Explore market share, coverage footprint, medical policies, and prior authorization requirements.
- Health insurance payers
- Medical policies
- State presence
Search NUCC provider taxonomy codes by code, specialty name, grouping, or classification. Open any result for definitions, NPI volume, and related billing and policy context.
Search CPT modifiers by code or name. Open any result for plain-language descriptions, when to use each modifier, clinical scenarios, and related payer policies.
Search payer prior authorization policies by drug, procedure, or policy name. Filter by payer, specialty, and effective year across 100+ payers' published policies.
Find payer timely filing policies: claim submission deadlines, corrected claim windows, and appeal timeframes, with effective dates and source documents.
Search payer coverage criteria and medical necessity requirements by drug, procedure, or payer across 21,000+ policies from 170+ payers.
Claims submission, prior authorization, provider services, and appeals contacts for health insurance payers: phone, fax, mailing address, and email, with the purpose and line of business for each.