Megan Crissey, COTA
Occupational Therapy Assistant · Houston, TX 77086 · NPI 1164989489 · 1 payer file
68%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Megan Crissey, COTA $65.28 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 36 contract rows for this clinician and code, from $48.74 to $87.42; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston occupational therapy assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $65.28median of 36 rows · $48.74–$87.42 | $96.33 | 68% | above 12% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $94.41median of 24 rows · $71.93–$123.85 | $137.41 | 69% | above 12% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston occupational therapy assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $77.56median of 24 rows · $64.87–$96.01 | $82.68 | 94% | not typically billed by occupational therapy assistants |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $130.41median of 24 rows · $109.22–$161.21 | $138.62 | 94% | not typically billed by occupational therapy assistants |
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 Megan Crissey, COTA performs these services, and they are kept out of the benchmark above.