How to Ask an Insurance Company for a Raise
Rent, staffing, compliance, and technology costs keep climbing. For many therapy practices that accept insurance, reimbursement rates have barely moved. That gap shows up everywhere: in what you can pay clinicians, how many clients you can serve, and whether staying in-network still makes sense.
Here’s what many practice owners don’t realize: you can ask an insurance company for a rate increase. Payers do renegotiate, but rarely because a practice asks nicely. They respond to a clear business case that speaks to their own priorities.
This guide shows you how to build that case. It’s built from letters actually sent to insurance payers by a Pennsylvania group practice. Plus the AI prompt used to write them. Use it as a starting point, not a script; the strongest letters are the ones tailored to what the specific payer says it cares about.
Want the prompt and letter in one place? Download the free 2-page Insurance Rate Increase Toolkit: the AI prompt plus a sample letter, ready to customize for each payer.
The Core Strategy: Why Insurance Companies Raise Reimbursement Rates
Insurance companies don’t raise your rate because you asked nicely. They raise it when you make a business case that connects to something they already care about i.e. network adequacy, quality metrics, member access, health equity, or cost avoidance. The letters that work hardest do three things:
1. State the ask clearly and early: a specific percentage, not “please consider”
2. Make the case in the payer’s own language — not just “we’re great,” but “we solve a problem you’ve publicly said you have”
3. Create a reason to respond by a deadline: a contract renewal date is the natural one
The biggest lever isn’t the rate comparison table. It’s researching each payer’s own website, press releases, and provider materials to find their stated priorities and then showing how your practice already meets them.
How to Negotiate an Insurance Rate Increase: Step by Step
Step 1: Pull your reimbursement data
Know your rate with this payer for your most common CPT codes (90837, 90791, 90834, etc.), and know how that rate compares to your other payers. The payer paying you the least gives you the most natural argument (“bring us up to market”).
If pulling these numbers is harder than it should be, it may be time to clean up your billing and revenue-cycle workflows.
Step 2: Identify your leverage
A contract renewal or credentialing anniversary date. Without one, the letter is easy to file away; with one, it forces a response.
Step 3: Research the payer, not just your own practice
Look at the payer’s public site for:
• Any stated commitment about access to care (wait times, “days to appointment”)
• Age ranges or populations they specifically say they cover (e.g., “behavioral health starting at age 6”)
• Network adequacy language in their provider manual
• Health equity, language-access, or diversity commitments
• Employer-facing ROI claims about behavioral health (cost savings from reduced ER visits, etc.)
• Quality metrics they’re measured on (HEDIS measures like Follow-Up After Hospitalization/ED Visit for Mental Illness are common for behavioral health)
Step 4: Match your practice’s actual capabilities to what you found
Only use points you can back up: wait time, panel size, specialties, languages, locations, satisfaction data.
Step 5: Draft, then sharpen the ask
State a specific percentage or dollar target. If they’re your lowest payer, say so directly.
Not sure where to start? Our free 2-page toolkit gives you the AI prompt and a sample letter so your first draft is already structured around the payer’s priorities.
Download the Free Insurance Rate Increase Toolkit
Ready to write your letter? Our free 2-page toolkit puts everything you need in one place:
The AI prompt. Copy, fill in your practice details, and let AI research the payer’s stated priorities before it drafts.
The sample letter. A proven structure to check and refine your draft, including:
• A clear, upfront rate increase request tied to your renewal date
• A “Why now” section for cost drivers and rate comparisons
• A section that connects your practice to the payer’s own stated priorities, with examples
• A “value we provide” section for panel size, locations, specialties, and satisfaction data
• A professional close that invites a conversation
Get the free toolkit → Enter your email and we’ll send it straight to your inbox.
Mistakes to Avoid When Asking for a Rate Increase
• Don’t threaten termination unless you mean it. It only works as leverage if you’re actually willing to follow through — payers can tell the difference.
• Don’t reuse the same rate comparison payer as your only proof point. If one payer is your highest, using it as the benchmark in every other letter makes the argument feel copy/dpasted. Vary it, or use a blended market average when you have it.
• Match the tone to the relationship. A letter to your highest paying payer (asking to maintain parity) should read differently than a letter to your lowest paying payer (asking to catch up). Same structure, different urgency.
• Get your numbers right before you send anything. A rate comparison table with an error undermines the whole letter.
Frequently Asked Questions
Can therapists negotiate insurance reimbursement rates?
Yes. Your rates are set by your provider contract, and contracts can be revisited. The strongest requests make a business case tied to the payer’s own priorities, such as member access, network adequacy, and quality metrics.
When is the best time to ask an insurance company for a rate increase?
Ahead of your contract renewal or credentialing anniversary date. A clear deadline gives the payer a reason to respond instead of filing your letter away.
How much of a rate increase should I ask for?
Ask for a specific percentage or dollar amount, not a vague request. Base it on your own data, such as how far this payer’s rate falls below your other payers or the regional market rate.
What should a rate increase letter to an insurance company include?
A clear ask stated early, the reasons behind it, how your practice supports the payer’s stated priorities, the value you provide, and a requested effective date. Our free Rate Increase Toolkit walks you through each section.
Can I use AI to write my insurance rate increase letter?
Yes. Use the prompt in our free toolkit, which tells the AI to research the payer’s website before writing. Always check every number and claim before you send it.
Start Your Rate Increase Request Today
Your reimbursement rates shape what your practice can offer clients and clinicians. A well researched letter, sent before your renewal date, is one of the simplest ways to change them.
Download the free Insurance Rate Increase Toolkit: AI prompt + sample letter →
Want a second set of eyes on your payer strategy or overall revenue plan? Learn about our business consulting for private practice owners, or start with a brief consult.