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Product Info

EncoderPro.com for Payers is designed to meet the specific needs of health insurance companies, self-insured employers and third-party administrators.

This comprehensive reference service provides up-to-date coding and coverage information on physician services, professional outpatient services and facility inpatient services. In addition, this broad online coding and reference tool includes ambulatory surgery center and hospital outpatient prospective payment system reference content, including revenue code crosswalks to CPT® and DRG/MDC information.

Note from product manager:

My name is Ryan Devey and I am the Product Manager for EncoderPro.com for Payers. Having worked for several payer organizations, I always wished I had more efficient access to coding guidelines and continuing education units. Particular to E/M code auditing, I wished I had the ability to better understand the E/M guidelines and how a code level was determined. Now I am more committed than ever to provide great E/M tools and content, especially with the 2021 E/M changes on the horizon. This is why we created EncoderPro.com Plus to address these areas. See more about EncoderPro.com Plus on the right side of this page.



Optum360® is committed to ensuring that you have the information you need to effectively and efficiently address COVID-19 from a medical coding, billing and reimbursement perspective. We have compiled information from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS), so you can easily access the most up-to-date medical code detail and effective dates in one convenient place on our COVID-19 resource page.

If you subscribe to EncoderPro.com for Payers, please sign in, then reference the "What's New" or "News" sections for COVID-19 guidance.


Consider becoming an EncoderPro.com Plus subscriber, you'll enjoy customized access to EncoderPro.com features and functionality specific to your organizational needs. You can also access Optum360® content at a fraction of the price previously available.

EncoderPro.com Plus includes:

  • Access up to 25 AAPC or 25 AHIMA CEUs through CareerWize.
  • Customized code search results based on your specialty. Limit code searches to only those that impact your organization.
  • Quick and easy access to E&M review tools. We know E&M is the most frequently coded section of codes and often the most difficult.
  • Access to historical coding content at a fraction of the price.
  • Additional Coders' Dictionary content for more clinical term clarification than ever before.

Request a demo today or gain access to EncoderPro.com Plus today by contacting us via email or by calling 1-800-464-3649, option 1.