Rachel Hanford, RN, MSN, ACNP-BC
Acute Care Nurse Practitioner · Houston, TX 77030 · NPI 1114241643 · 1 payer file
134%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Rachel Hanford, RN, MSN, ACNP-BC $129.20 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 42 contract rows for this clinician and code, from $101.98 to $151.98; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston acute care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $129.20median of 42 rows · $101.98–$151.98 | $96.33 | 134% | above 86% of 469 Houston acute care nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $210.22median of 42 rows · $156.37–$267.26 | $137.41 | 153% | above 87% of 468 Houston acute care nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston acute care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $141.98median of 24 rows · $129.64–$179.96 | $82.68 | 172% | not typically billed by acute care 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 Rachel Hanford, RN, MSN, ACNP-BC performs these services, and they are kept out of the benchmark above.