Andrea Mccoy, NP
Gerontology Nurse Practitioner · Houston, TX 77002 · NPI 1053032482 · 1 payer file
50%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Andrea Mccoy, NP $48.17 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 96 contract rows for this clinician and code, from $34.82 to $76.68; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gerontology nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $48.17median of 96 rows · $34.82–$76.68 | $96.33 | 50% | above 0% of 162 Houston gerontology nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $70.33median of 96 rows · $51.38–$108.35 | $137.41 | 51% | above 0% of 162 Houston gerontology nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gerontology nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $56.48median of 96 rows · $45.10–$73.84 | $82.68 | 68% | not typically billed by gerontology nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $94.97median of 96 rows · $75.75–$124.22 | $138.62 | 69% | not typically billed by gerontology 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 Andrea Mccoy, NP performs these services, and they are kept out of the benchmark above.