Sarah Lonsdale Bledsoe, LCSW
Clinical Social Worker · Houston, TX 77006 · NPI 1134605090 · 2 payer files
112%of Medicare
Cigna — Texas Connect (individual & family) pays Sarah Lonsdale Bledsoe, LCSW $107.97 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.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $107.97 | $96.33 | 112% | above 2% of 41 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 20 rows · $55.30–$81.60 | $96.33 | 72% | above 25% of 780 Houston clinical social workers on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $156.34 | $137.41 | 114% | above 2% of 41 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 20 rows · $81.21–$118.37 | $137.41 | 73% | above 40% of 783 Houston clinical social workers on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $94.48 | $82.68 | 114% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.73–$78.30 | $82.68 | 81% | not typically billed by clinical social workers | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $152.97 | $138.62 | 110% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 12 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by clinical social workers |
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 Sarah Lonsdale Bledsoe, LCSW performs these services, and they are kept out of the benchmark above.