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Physicians Health Plan
Physicians Health Plan is a health insurer. They report 580 insurance plans covering 8.2K providers across 53K billing codes.
Source: public Transparency in Coverage filesRefreshed monthly, latest August 202615 monthly releases tracked
Monthly release
580
Plans
8.2K
Providers (NPIs)
XX% vs prior month
1.4K
Tax IDs
XX% vs prior month
53K
Billing codes
1.9M
Rate rows
XX% vs prior month
August 2026 release
What's in Physicians Health Plan's data
A profile of the machine-readable files Physicians Health Plan publishes, after PayerPrice parses and normalizes them.
Billing code types
Distinct codes and rate rows by code system
CodesRows
- HCPCS38K1M54%
- CPT12K790K42%
- CDT1.5K30K1.6%
- RC56017K0.9%
- MS-DRG77015K0.8%
- ICD1101.9K0.1%
- HIPPS110220<0.1%
- PROC129<0.1%
Billing class
Professional vs. institutional rate rows
- Institutional970K52%
- Professional890K48%
Negotiation arrangement
How each rate is expressed
- Fee Schedule700K38%
- Percentage590K32%
- Negotiated570K31%
- Per Diem510<0.1%
Plan identifiers
HIOS IDs mark individual and small-group plans; EINs mark employer plans
- HIOS ID498.5%
- EIN53092%
Providers by type
Distinct NPIs by entity type
- Individual (Type 1)7.6K92%
- Organization (Type 2)6407.7%
Tax IDs by type
How provider groups are identified
- EIN1.4K98%
- NPI (Individual)292.1%
Top states
States with the most providers in network
- Michigan7.5K
- Illinois74
- Florida71
- Ohio67
- California65
- Texas45
Top specialties
Provider taxonomies with the most NPIs
- Clinical Social Worker830
- Physician Assistant420
- Diagnostic Radiology Physician390
- Family Nurse Practitioner380
- Family Medicine Physician340
- Certified Registered Nurse Anesthetist310
These are the files. Want the rates inside them?
Look up Physicians Health Plan's negotiated rates by provider, TIN, billing code and plan.
Month-over-month history
Track how network size and rate volume change with each monthly release.
| Month | Plans | NPIs | Tax IDs | Billing codes | Rate rows |
|---|---|---|---|---|---|
| August 2026 | 580 | 8.2K | 1.4K | 53K | 1.9M |
| July 2026 | 580 | 9.4K | 1.6K | 53K | 2M |
| June 2026 | 80 | 7.6K | 1.4K | 53K | 740K |
| April 2026 | — | — | — | — | |
| March 2026 | — | — | — | — |
Data quality scorecard
5/6Good
This payer scores 5/6 on data quality (Good). Areas that don't meet the threshold: low derived/percentage rates.
Evaluated on the August 2026 release.
Professional & Institutional Rates
Data includes both professional and institutional billing class rates
Valid Tax IDs
More than 80% of Tax IDs are EIN or NPI (Organization) type
HIOS Plan
Data includes at least one HIOS-identified plan
Low Derived/Percentage Rates
10% or more of negotiation entries are derived or percentage type
Standard Code Coverage
Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries
Common Taxonomies
NPIs in the dataset cover at least 50 distinct provider taxonomies
How the score works
Each monthly release is checked against six criteria. 5–6 passing criteria rate Good, 3–4 rate Acceptable, and 0–2 rate Poor.
Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.
Access the data
Physicians Health Plan's negotiated rates, in the tools your team already uses
PayerPrice turns raw transparency files into one clean, normalized dataset across 180+ payers, refreshed every month. Pick how you want to work with it.
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Pull negotiated rates, providers and benchmarks into your own products and pipelines.
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Snowflake & Databricks
Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.
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MCP server
Ask Claude, Cursor or your own agents questions like "What does Physicians Health Plan pay for CPT 99213 near me?"
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Frequently asked questions
About Physicians Health Plan's price transparency data.
What price transparency data does Physicians Health Plan publish?
Physicians Health Plan's August 2026 Transparency in Coverage files list 580 plans, 8.2K providers (NPIs), 1.4K tax IDs and 53K billing codes, for 1.9M negotiated rate rows in total.
Which states does Physicians Health Plan's network cover?
Physicians Health Plan's files include providers in 50 states. The states with the most in-network providers are Michigan, Illinois, Florida, Ohio, California.
How often is Physicians Health Plan's data updated?
Payers must post updated machine-readable files every month. PayerPrice processes Physicians Health Plan's files monthly; the latest processed release is August 2026, and 15 monthly releases are available.
What is the Transparency in Coverage rule?
Since July 2022, the federal Transparency in Coverage rule has required most group health plans and health insurers to publish machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, updated monthly. These files are the source for the data on this page.
How can I access Physicians Health Plan's negotiated rates?
Start a free PayerPrice trial to search Physicians Health Plan's rates in the web app, or book a demo to get the full dataset through the REST API, SQL in Snowflake or Databricks, or AI assistants through the PayerPrice MCP server.