---
title: Fallon Health ABA coverage (MassHealth ACPPs).
url: "https://carelu.com/payers/fallon-health-massachusetts"
markdown_url: "https://carelu.com/payers/fallon-health-massachusetts.md"
state: MA (Massachusetts)
payer: Fallon Health (MassHealth ACPPs)
kind: Medicaid managed care plan (MCO)
parent_program: MassHealth
description: "How Fallon Health's MassHealth ACPPs handle ABA — behavioral health through Carelon on the state-baseline criteria and standard form, 6-month authorizations, and Fallon's place in the 2026 supervision-ratio audit."
last_reviewed: September 2026
vob_data_updated: 2026-07-23
---

# Fallon Health ABA coverage (MassHealth ACPPs).

_Payer Guide · Fallon Health · Last updated September 2026 · 6 primary sources_

> Three ACPPs (2023 roster), Carelon-run BH, state-baseline rules; first-wave audit recoupments.

Fallon Health fields Accountable Care Partnership Plans in central and western Massachusetts — three as of the April 2023 state roster (Fallon 365 Care with Reliant, Fallon-Atrius, and the Berkshire Fallon Health Collaborative), a lineup worth re-verifying given ownership shifts since. For ABA, Fallon publishes no distinct policy of its own: behavioral health runs through Carelon, on the state-baseline criteria and the Massachusetts Standard ABA PA Form. Fallon's plans were among the six in MassHealth's 2026 supervision audit and received first-wave recoupment letters.

This plan administers the **MassHealth** ABA benefit: the state rules are the floor, and this page covers what the plan layers on top. Read it together with the [MassHealth (Massachusetts Medicaid) guide](https://carelu.com/payers/masshealth-massachusetts-medicaid).

## Prior authorization and diagnosis at a glance

- **Prior auth for the assessment**: Required — via the Carelon process on the MA standard form; plan-level specifics not published, verify with Carelon [6][1]
- **Prior auth for treatment**: Required — 6-month authorization periods (per statewide practice), via Carelon [6][1]
- **Autism diagnosis required?**: Yes — ASD via comprehensive DSM-aligned assessment; from 1/1/2026 also sole-diagnosis Down syndrome (state baseline) [6][5]

## At a glance

- **Plan type:** MassHealth ACPPs — 3 per the 2023 roster (verify current lineup)
- **BH administrator:** Carelon Behavioral Health
- **Clinical rules:** State baseline — no distinct Fallon ABA policy found
- **Prior auth:** Required — standard-form process; 6-month authorization periods
- **Hour caps:** None published — medical necessity based
- **Supervision watch:** One of the six audited plans; first-wave recoupment letters received

## State baseline via Carelon

Fallon has no published ABA criteria of its own — its MassHealth plans defer to Carelon's UM on the state-baseline rules: PA required for assessment and treatment on the Massachusetts Standard ABA PA Form, authorizations in 6-month periods, no published hour caps, medical necessity per EPSDT. Plan-level submission specifics (including whether Fallon requests route through Carelon's ProviderConnect like MBHP's) aren't published — confirm the channel with Carelon before the first submission rather than assuming the MBHP flow. [1][2]

## Two verification flags

First, the roster: the 2023 ACPP lineup may have shifted — Atrius's ownership changes in particular make the Fallon-Atrius entry worth confirming before onboarding a family who names it. Second, the audit: Fallon is named among the six ABA-administering plans in MassHealth's CY2024 supervision-ratio audit and received recoupment letters in the first wave, so the 1:10 97155-to-97153 floor applies to Fallon claims with the same force as everywhere in the Carelon universe. [2]

## Intake gates

The questions that decide whether a family can start with Fallon Health (MassHealth ACPPs), and what they have to bring.

- **Age limit**: EPSDT sets the bound, and nothing else does. ABA is covered for MassHealth Standard and CommonHealth members under 21, and for Family Assistance members under 19 — with no lower age bound and no dollar, visit or unit-of-service cap underneath it. For the youngest referrals the binding rule is non-duplication rather than age: ABA cannot duplicate services the child already receives through Early Intervention. From 1/1/2026 the second diagnostic pathway (sole-diagnosis Down syndrome) rides the same age structure. [5]
- **Who may diagnose**: The standard form names them, and the list is broader than "send them to a developmental pediatrician." For autism it requires "A comprehensive assessment completed by a licensed physician (i.e. PCP, etc.), advanced practice registered nurse, physician's assistant, or psychologist experienced in the diagnosis and treatment of ASD with developmental or child/adolescent experience which aligns with DSM criteria across ASD core deficits." For the 1/1/2026 pathway it requires instead "A diagnosis of Down Syndrome (Trisomy 21) confirmed by genetic testing." Note the two signatures are different people: the diagnostician writes the assessment, while the form itself "should" be completed by the BCBA rendering and/or supervising the services — an analyst the performance specification requires to be a LABA licensed under 262 CMR 10.00. Fallon takes the Massachusetts Standard ABA PA Form through Carelon, so these are the operative requirements; no Fallon-specific diagnostic criteria are published. [6]
- **Diagnostic tools required**: No instrument is mandated. The standard form requires a comprehensive assessment "which aligns with DSM criteria across ASD core deficits" without naming ADOS-2, ADI-R, CARS-2 or any other tool, and the performance specification names no diagnostic battery either; the Down syndrome pathway replaces the instrument question entirely with genetic testing. Massachusetts puts its measurement requirement downstream of intake instead — in progress documentation and medical-necessity review, not in the diagnostic gate. [6]
- **Referral required?**: No referral and no physician order is a condition of authorization. The Massachusetts Standard ABA PA Form has no referral field and is completed by the rendering or supervising BCBA/LABA, and the performance specification's referral language is about timeliness rather than permission: "Fourteen calendar days from referral is the Medicaid standard of timely provision for services established in accordance with 42 CFR 441.56(e)," with a waitlist duty (and an obligation to hand caregivers other regional providers' contact information) where the provider cannot start inside it. What the state does require is PCP evidence in the chart rather than at the door: the complete medical record must hold "Referral and assessment documentation" and "Documentation confirming physical examinations by a PCP," and the continued-services pages ask for a dated primary-care care-coordination entry. [3][6]
  - Ask the plan: Carelon Behavioral Health provider relations for the Fallon line of business — confirm the MBHP performance specification is applied verbatim.
- **Prior-auth decision time**: Carelon decides for Fallon, on the federal clock. Carelon's current Massachusetts addendum (Fallon Health section) lists MassHealth non-urgent decisions "Within 7 Calendar Days" and urgent decisions "Within 72 hours from request." Both apply to pre-service and concurrent review. Under the EOHHS contract "based on 42 CFR Part 438," the member, representative or provider may request an extension of up to 14 calendar days. "When the specified time frames for standard and expedited prior authorization requests expire before Carelon makes a decision, an adverse action notice will go out to the member on the date the time frame expires." No ABA reauthorization lead time is published for Fallon. The standard form allows continued-services requests in up to 6-month windows. [7][8][6]
  - Ask the plan: Carelon (Fallon Health program): the lead time it wants before an ABA authorization ends.
- **Other insurance (who pays first)**: Fallon pays last for MassHealth ACO members, and its authorization rules still apply when it is secondary. Fallon's April 2026 billing manual says "For services to be considered for payment as a secondary insurer, Fallon Health's policy and procedures for referrals and authorizations must be followed." So get the Fallon/Carelon ABA PA even when commercial coverage is primary. Bill the primary first and send its EOB with the claim. Dependent children follow the birthday rule: "the insurance of the parent whose birth date occurs first in the calendar year." Behavioral-health claims go to Carelon. Its Fallon BH manual (Sept 2021 revision) requires secondary claims "with a copy of the primary insurance's explanation of benefits report and received ... within 60 days of the date on the EOB." Fallon's general billing manual allows 120 days from the other carrier's EOB, so hold to the shorter 60-day window for ABA. Use the TPL Indicator Form to report other coverage to EOHHS. MassHealth's rule adds that a primary denial for missing PA or for being out of network forfeits the secondary payment (130 CMR 450.316(B)). TRICARE pays before MassHealth: "By law, TRICARE pays after all other health insurance, except for: Medicaid." [9][10][11][12]
  - Ask the plan: Carelon (Fallon program): confirm the current BH secondary-claim filing window. The only Fallon BH manual posted is the September 2021 revision.
- **Diagnosis recency** _(ask the plan)_: Not published. Neither the Massachusetts Standard ABA PA Form nor the Carelon/MBHP performance specification sets a maximum age for the diagnostic evaluation — the form asks for the current ICD-10 diagnosis and, on a "Request for initial evaluation," a copy of the comprehensive assessment, but names no recency window. What the form does date is utilization, not diagnosis: the continued-services page makes the BCBA attest whether at least 75% of the previously authorized direct-service hours were used. [6][3]
  - Ask the plan: Carelon Behavioral Health provider relations for the Fallon line of business — confirm the MBHP performance specification is applied verbatim.
- **Telehealth** _(ask the plan)_: Permitted at the family's request, with no code list and no POS rule. The ABA provider "may deliver services and consultation via a Health Insurance Portability and Accessibility Act (HIPAA)-compliant telehealth platform at the parent/caregiver's request and if the service can be effectively delivered via telehealth as part of the intervention when appropriate," with the rationale documented and the documentation reflecting "clinical considerations for appropriateness across any service components being delivered via telehealth." Two guardrails ride along: telehealth "must not replace in-person availability," and the member or family "may rescind consent for telehealth at any time without risk of interruption of services." No per-code restriction, modifier or place-of-service code is published. The specification published at providers.masspartnership.com is MBHP's; Carelon has published no separate Fallon ABA specification that could be located. [3]
  - Ask the plan: Carelon Behavioral Health provider relations for the Fallon line of business — confirm the MBHP performance specification is applied verbatim.

## Delivery and billing rules

Coverage decides whether Fallon Health (MassHealth ACPPs) pays. These decide whether the claim survives: staffing and supervision, concurrent billing, per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under.

- **Supervision** _(ask the plan)_: Fallon’s MassHealth ACPPs route ABA to Carelon, and the MassHealth-wide supervision band is the floor the state audited against: no less than 10% of Behavior Technician direct service hours in LABA supervision, not above 25% without documented clinical rationale, minimum one hour per month for members at 10 or fewer direct hours per month. The specification published at providers.masspartnership.com is MBHP’s; Carelon has not published a separate Fallon-specific ABA specification that could be located. [3]
  - Ask the plan: Carelon Behavioral Health provider relations for the Fallon line of business — confirm whether the MBHP performance specification is applied verbatim.
- **Daily limits / MUEs** _(ask the plan)_: Massachusetts is a no-cap state that nonetheless has one published per-day number. There are no annual, lifetime or unit-of-service ceilings on the EPSDT benefit, and 101 CMR 358.03 is a rate regulation, not a limit regulation — it fixes per-15-minute rates and states they are “full compensation” including “necessary administration and professional supervision associated with patient care.” The only per-day cap in the performance specification is for group instruction, which “may occur up to 4.5 hours a day as clinically indicated, in groups of 2-8 Members.” No per-code MUE regime is published, so what bites in practice is medical-necessity review and the supervision-ratio audit, not a unit edit. [4]
  - Ask the plan: Carelon provider relations for Fallon; the rate regulation is statewide, the claim edits are not.
- **Place of service** _(ask the plan)_: Home and community, with school carved out. ABA “is delivered by a contracted and credentialed provider in a variety of settings within a Member’s home and community,” and “services provided in a school setting are distinct and separate from those covered by the health plan and are typically covered by the educational system’s special education resources as part of the Individualized Education Program (IEP) pursuant to Public Law 94-142.” Providers “must not direct, limit, or discourage access to other medically necessary or school-based services.” Transition planning contemplates moving a member “from a center based setting to home/community settings,” so centers are in scope. Group homes are not addressed. No Fallon-specific deviation was located. [3]
  - Ask the plan: Carelon provider relations for the Fallon line of business.

## What intake should collect for Fallon Health (MassHealth ACPPs)

- **Exact plan name:** Fallon 365 Care, Fallon-Atrius, or Berkshire Fallon — and verify the plan still exists in its 2023 form.
- **Diagnostic evaluation:** ASD assessment (or Down syndrome genetic-testing pathway from 1/1/2026) for the standard form.
- **Submission channel:** Confirm the Carelon submission route for Fallon specifically before the first request.
- **Supervision capacity:** First-wave audit plan — hold the 1:10 97155:97153 ratio in scheduling.

Free verification-call checklist (PDF): https://carelu.com/downloads/aba-verification-call-checklist.pdf

## Verification of benefits (VOB) data

How Fallon Health (MassHealth ACPPs) ABA benefits route and read on an eligibility check. Data last updated 2026-07-23.

### EDI routing

- **Payer ID (pVerify):** 00092 — pVerify also separately lists a 'Fallon Community Health Plan (Exception)' entry (01099) — confirm which code applies before automating routing.
- **Supports 270/271 eligibility:** Yes
- **Behavioral health administrator:** Carelon Behavioral Health (Beacon) — administers ABA directly for Fallon's MassHealth ACPPs
- **BH administrator payer ID:** 43324 (claim.md) / BHOVO (Stedi) / 00831 (pVerify) / ISA Receiver ID BEACON963116116 (Carelon national companion guide) — genuinely multiple identifiers across clearinghouses for the same Carelon/Beacon entity, not resolved to one canonical number. — Carelon/Beacon's own Fallon-specific provider manual (Sept 2021, stale) confirms EDI submission structurally ("use Beacon's Emdeon Payer ID") but does not print the actual numeric ID anywhere in its text — confirm directly with Carelon provider services.
- **ABA rides on:** behavioral health benefit
- **Two-hop verification required:** Yes

### Code-level coverage

| Code | Covered | Prior auth | Unit cap | Place of service | Telehealth | Modifiers |
| --- | --- | --- | --- | --- | --- | --- |
| 97151 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97152 | Yes (assumed covered under the comprehensive EPSDT benefit; not separately priced in the current 101 CMR 358.03 fee schedule — see Layer 4 rates) | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97153 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97154 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | 18 units/day (≤4.5 hrs), group size 2–8 members per day | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97155 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97156 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97157 | Yes | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | 18 units/day (≤4.5 hrs), group size 2–8 members per day | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 97158 | Yes (assumed covered under the comprehensive EPSDT benefit; not separately priced in the current 101 CMR 358.03 fee schedule — see Layer 4 rates) | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 0362T | Yes (assumed covered under the comprehensive EPSDT benefit; not separately priced in the current 101 CMR 358.03 fee schedule — see Layer 4 rates) | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |
| 0373T | Yes (assumed covered under the comprehensive EPSDT benefit; not separately priced in the current 101 CMR 358.03 fee schedule — see Layer 4 rates) | Required — PA is required for all ABA services/hours/units, assessment and treatment alike | — | home/community (default), center-based/clinic (documented clinical justification required per the Carelon/MBHP performance spec), school (carved to IEP/DESE — not billed to the health plan) | Yes, as a modality — allowed at parent/caregiver request when clinically appropriate per the Carelon/MBHP performance spec; must not replace in-person availability. No telehealth modifier (GT/95) or POS code is specified in the spec. | — |

Code notes:

- **97151, 97153, 97155, 97156:** Fallon's own Carelon-administered provider manual confirms EDI submission structurally but does not restate code-level billing mechanics — this entry is inferred from the statewide Carelon/MBHP pattern, not independently confirmed against a Fallon-specific coding document.
- **97152, 97158, 0362T, 0373T:** Not separately priced in the current fee schedule — see Layer 4 for the individual-consideration note. Fallon's own Carelon-administered provider manual confirms EDI submission structurally but does not restate code-level billing mechanics — this entry is inferred from the statewide Carelon/MBHP pattern, not independently confirmed against a Fallon-specific coding document.
- **97154, 97157:** Group-session cap and size come from the Carelon/MBHP performance spec, not a fee-schedule/coding source. Fallon's own Carelon-administered provider manual confirms EDI submission structurally but does not restate code-level billing mechanics — this entry is inferred from the statewide Carelon/MBHP pattern, not independently confirmed against a Fallon-specific coding document.

### Contacts

- **Provider services phone:** 1-800-397-1630
- **Phone menu path:** For member eligibility, authorization confirmation, and claims status specifically, call 1-888-421-8861 (Beacon Member Services). For Fallon Health's own (non-BH) medical/administrative line, the manual separately lists 1-800-868-5200.
- **Hours:** 8:00 a.m.-8:00 p.m. ET, Monday-Friday (National Provider Service Line, shared across Carelon/Beacon's health-plan clients including Fallon)
- **Portal:** [Beacon/Carelon eServices](https://www.beaconhealthoptions.com)

Questions to ask on a verification call:

- What is Carelon/Beacon's actual numeric EDI/Emdeon payer ID for Fallon Health claims (Fallon's own provider manual confirms the process but doesn't print the number)?
- Does Fallon support real-time single-patient 270/271 eligibility checks, or only batch?
- Are there any Fallon-specific per-code unit caps or billing modifiers that differ from the statewide Carelon/MBHP baseline?

### VOB data sources

- https://pverify.com/payer-list/ (accessed 2026-07-23)
- https://www.carelonbehavioralhealth.com/content/dam/digital/carelon/cbh-assets/documents/ma/behavioral-health-policy-and-procedure-manual-for-providers-fallon.pdf (accessed 2026-07-23; source document older than 18 months)
- https://www.claim.md/payer/43324 (accessed 2026-07-23)
- https://www.stedi.com/healthcare/network/carelon-behavioral-health (accessed 2026-07-23)
- https://www.mass.gov/doc/masshealth-standard-companion-guide-health-care-eligibilitybenefit-inquiry-and-information-response-270271-0/download (accessed 2026-07-23; source document older than 18 months)
- https://www.mass.gov/doc/rates-for-applied-behavior-analysis-effective-october-1-2024-0/download (accessed 2026-07-23; source document older than 18 months)
- https://providers.masspartnership.com/pdf/PerfSpec-ABA.pdf (accessed 2026-07-23)

## Common questions

### Does Fallon Health cover ABA?

Yes — its MassHealth ACPPs carry the state-baseline EPSDT benefit, with behavioral health (including ABA authorization) administered by Carelon on the Massachusetts Standard ABA PA Form in 6-month periods.

### Does Fallon have its own ABA policy?

No distinct Fallon ABA criteria are published — it defers to Carelon UM and the state baseline. Confirm submission mechanics with Carelon directly.

## Primary sources

1. [MassHealth Managed Care Options — plan/BH-vendor map (April 2023)](https://abh.memberclicks.net/assets/docs/KeepingCoverage/2023%20MassHealth%20Accountable%20and%20Managed%20Care%20Options%20031723.pdf)
2. [MassHealth ABA supervision audit & recoupment (Acuity News)](https://acuity.news/regulation/masshealth-aba-supervision-audit-recoupment-litigation-2026/)
3. [Carelon/MBHP Performance Specifications — Applied Behavior Analysis (upd. Feb 15, 2026)](https://providers.masspartnership.com/pdf/PerfSpec-ABA.pdf)
4. [101 CMR 358.03 Rate Provisions (Cornell LII mirror)](https://www.law.cornell.edu/regulations/massachusetts/101-CMR-358-03)
5. [AIRC — MassHealth ABA Coverage factsheet](https://massairc.org/factsheets/masshealth-aba-coverage/)
6. [MA Standard ABA PA Form (MassHealth version, upd. 3/12/2026)](https://www.wellsense.org/hubfs/Forms/Provider_Forms/Applied_Behavioral_Analysis_Prior_Authorization_Form_MassHealth.pdf)
7. [Carelon Behavioral Health — Massachusetts Addendum (114_0526 rev.)](https://www.carelonbehavioralhealth.com/content/dam/digital/carelon/cbh-assets/documents/ma/massachusetts-provider-addendum.pdf)
8. [42 CFR 438.210(d) — Medicaid managed care authorization timeframes (eCFR)](https://www.ecfr.gov/current/title-42/section-438.210)
9. [Fallon Health Provider Manual — Billing procedures (rev. April 2026)](https://fallonhealth.org/-/media/Files/ProviderPDFs/PMbilling.ashx)
10. [Carelon (Beacon) Behavioral Health Policy and Procedure Manual for Providers — Fallon Health (rev. Sept 2021)](https://www.carelonbehavioralhealth.com/content/dam/digital/carelon/cbh-assets/documents/ma/behavioral-health-policy-and-procedure-manual-for-providers-fallon.pdf)
11. [130 CMR 450.316 — MassHealth third-party liability: requirements (Cornell LII mirror)](https://www.law.cornell.edu/regulations/massachusetts/130-CMR-450-316)
12. [TRICARE — Using Other Health Insurance](https://tricare.mil/Plans/OHI)

Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed September 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.

Source: Carelu ABA Payer Directory — https://carelu.com/payers. Free to cite with attribution.