Analysis 01 · Prior authorization · CY2025

About one in seven treatment requests was denied last year.

Before a health plan will cover certain treatments, a doctor has to get it approved first. That is prior authorization, and for the first time plans are now required to publish how often they say yes and how often they say no.

Crossfoot collects those filings — 536 of them, from 96 insurers across 49 states — and puts them in one place, where they add up to a 13.6% denial rate. Every figure came from the plan's own document, and every one has been checked against itself. Some of them do not add up.

536
filings
96
organizations
49
states
42.8M
standard requests
490
logged coverage gaps
01 · Findings

Standard denial rate by market

Volume-weighted across all filings that publish counts. Every rate is computed from extracted counts — never generated.

Volume-weighted, all markets
13.6%
42.8M standard requests across 536 filings from 96 organizations in 49 states.
536 rows CSV · JSON · MySQL

Highest rates among plans with 1,000+ standard requests

02 · In this section

Four ways into the data

The full dataset also downloads as CSV or serves as JSON — the same numbers, no account, no key.