Melissa Vance, APN - BC
Adult Health Nurse Practitioner · Houston, TX 77030 · NPI 1023116605 · 1 payer file
128%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Melissa Vance, APN - BC $123.22 for a 99213 — Office visit, established patient, low complexity. Medicare pays $96.33 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare. The file lists 84 contract rows for this clinician and code, from $79.57 to $183.59; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston adult health nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $123.22median of 84 rows · $79.57–$183.59 | $96.33 | 128% | above 70% of 131 Houston adult health nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $174.14median of 84 rows · $117.29–$266.33 | $137.41 | 127% | above 70% of 131 Houston adult health nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston adult health nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $123.14median of 76 rows · $98.00–$176.17 | $82.68 | 149% | not typically billed by adult health nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $260.12median of 12 rows · $229.52–$306.04 | $138.62 | 188% | not typically billed by adult health nurse practitioners |
A payer’s file carries a rate for every code in the contract’s fee class, whether or not the clinician will ever bill it. These rows are real, and they are how the fee class shows through — but they are not evidence that Melissa Vance, APN - BC performs these services, and they are kept out of the benchmark above.