Jelina Marie Castillo
Pediatric Adolescent Medicine Physician · Houston, TX 77030 · NPI 1073141818 · 1 payer file
85%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Jelina Marie Castillo $81.82 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 20 contract rows for this clinician and code, from $65.18 to $96.26; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric adolescent medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $81.82median of 20 rows · $65.18–$96.26 | $96.33 | 85% | above 33% of 13 Houston pediatric adolescent medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $118.92median of 20 rows · $95.97–$139.91 | $137.41 | 87% | above 25% of 13 Houston pediatric adolescent medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric adolescent medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $81.70median of 12 rows · $72.08–$96.11 | $82.68 | 99% | not typically billed by pediatric adolescent medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $144.51median of 12 rows · $127.51–$170.02 | $138.62 | 104% | not typically billed by pediatric adolescent medicine physicians |
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 Jelina Marie Castillo performs these services, and they are kept out of the benchmark above.