> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Contract & Fee Schedule Management — Integration

> Version: 1.0 Last Updated: 2026-02-27 Status: ✅ Complete — 2026-02-28 Spec: PM-23 Contract & Fee Schedule Management Constitution Reference: Section 1.2 (Core…

**Version:** 1.0\
**Last Updated:** 2026-02-27\
**Status:** ✅ Complete — 2026-02-28\
**Spec:** [PM-23 Contract & Fee Schedule Management](../../../specs/pm/specs/PM-23-contract-fee-schedule-management.md)\
**Constitution Reference:** Section 1.2 (Core Independence), Section 1.3 (Integration Patterns)

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## Overview

PM-23 adds payer contract and contracted rate management: contracts with terms and effective/termination dates, rate schedules per contract (CPT, modifiers, rate, rate\_type), underpayment detection (ERA paid amount vs contracted rate), contract expiration alerts, and rate comparison reporting. It integrates with PM-07 (fee schedules), PM-08 (claim expected amounts), PM-09 (payment posting/variance), and PM-11 (analytics).

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## Integration Points (from spec)

| Dependency | Pattern          | Purpose                                                                                            | Status     |
| ---------- | ---------------- | -------------------------------------------------------------------------------------------------- | ---------- |
| **PM-07**  | Data (same core) | Fee schedules may reference contract or remain separate; contracted rates used for expected amount | 📋 Planned |
| **PM-08**  | Data (same core) | Claim expected amount from contracted rate when contract exists                                    | 📋 Planned |
| **PM-09**  | Data (same core) | Compare paid\_amount to contracted rate; flag underpayment                                         | 📋 Planned |
| **PM-11**  | Data (same core) | Contract performance analytics, rate comparison, underpayment reports                              | 📋 Planned |

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## Data Source Tables (PM-23)

| Table                 | Key Columns                                                                              | Used By                                                                        |
| --------------------- | ---------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------ |
| `pm_payer_contracts`  | organization\_id, payer\_id, effective\_date, termination\_date, status, deleted\_at     | Contract list, expiration alerts, rate lookup context                          |
| `pm_contracted_rates` | contract\_id, cpt\_code, modifiers, rate\_amount, rate\_type, effective\_date, end\_date | Expected amount (PM-07/PM-08), underpayment detection (PM-09), reports (PM-11) |

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## Platform Layer Usage

* **PM-07:** May consume contracted rates for fee schedule display or expected amount; link optional (contracted vs org-defined fee schedule).
* **PM-08:** When generating claim expected amount, look up contracted rate by payer + CPT + date; fallback to org fee schedule when no contract.
* **PM-09:** On payment posting, look up contracted rate for claim payer + line CPT; if paid\_amount \< rate, set underpayment flag (storage location TBD in implementation).
* **PM-11:** Read pm\_payer\_contracts and pm\_contracted\_rates for contract analytics, rate comparison across payers, underpayment reports.
* **Permissions:** `pm.contracts.view`, `pm.contracts.manage` gate UI; RLS enforces tenant isolation.

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## Event / API Contracts

* **Same-core data only.** No new event or API contracts; PM-07, PM-08, PM-09, PM-11 access tables via direct (RLS-scoped) queries or existing platform patterns.

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## Integration Matrix

| From       | To    | Pattern          | Status     | Doc      |
| ---------- | ----- | ---------------- | ---------- | -------- |
| PM (PM-23) | PM-07 | Data (same core) | 📋 Planned | This doc |
| PM (PM-23) | PM-08 | Data (same core) | 📋 Planned | This doc |
| PM (PM-23) | PM-09 | Data (same core) | 📋 Planned | This doc |
| PM (PM-23) | PM-11 | Data (same core) | 📋 Planned | This doc |

***

## References

* [PM-23 Spec](../../../specs/pm/specs/PM-23-contract-fee-schedule-management.md)
* [CROSS\_CORE\_INTEGRATIONS](./CROSS_CORE_INTEGRATIONS.md)
* [PM-08](./claims-management-submission-integration.md), [PM-09](./payment-posting-era-processing-integration.md), [PM-11](./revenue-cycle-dashboard-analytics-integration.md)