Edith Turner, LPC, LCDC
Professional Counselor · Houston, TX 77021 · NPI 1174277917 · 1 payer file
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Edith Turner, LPC, LCDC $68.89 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 40 contract rows for this clinician and code, from $53.95 to $81.60; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston professional counselors, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $68.89median of 40 rows · $53.95–$81.60 | $96.33 | 72% | above 10% of 1,205 Houston professional counselors on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $99.96median of 40 rows · $79.48–$118.37 | $137.41 | 73% | above 26% of 1,207 Houston professional counselors on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston professional counselors, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 36 rows · $57.94–$78.30 | $82.68 | 79% | not typically billed by professional counselors |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 18 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by professional 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 Edith Turner, LPC, LCDC performs these services, and they are kept out of the benchmark above.