Aileen Argueta
Counselor · Houston, TX 77054 · NPI 1073354981 · 1 payer file
68%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Aileen Argueta $65.46 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 116 contract rows for this clinician and code, from $52.15 to $83.23; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston counselors, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $65.46median of 116 rows · $52.15–$83.23 | $96.33 | 68% | above 6% of 101 Houston counselors on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $95.14median of 120 rows · $76.78–$120.73 | $137.41 | 69% | above 29% of 102 Houston counselors on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston counselors, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 36 rows · $57.67–$79.86 | $82.68 | 81% | not typically billed by counselors |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 30 rows · $102.01–$138.74 | $138.62 | 83% | not typically billed by counselors |
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 Aileen Argueta performs these services, and they are kept out of the benchmark above.