Beth Emmons, MSW, LICSW
Clinical Social Worker · Houston, TX 77008 · NPI 1174785893 · 2 payer files
87%of Medicare
UnitedHealthcare — Optum Behavioral Health pays Beth Emmons, MSW, LICSW $84.06 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 2 contract rows for this clinician and code, from $84.06 to $84.06; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | UnitedHealthcare — Optum Behavioral Health | $84.06median of 2 rows · $84.06–$84.06 | $96.33 | 87% | above 1% of 68 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $61.40median of 134 rows · $53.11–$109.93 | $96.33 | 64% | above 7% of 780 Houston clinical social workers on this plan | |
| 99214Office visit, established patient, moderate complexity | UnitedHealthcare — Optum Behavioral Health | $118.50median of 2 rows · $118.50–$118.50 | $137.41 | 86% | above 1% of 68 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 154 rows · $76.90–$159.65 | $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 | UnitedHealthcare — Optum Behavioral Health | $65.10median of 2 rows · $65.10–$65.10 | $82.68 | 79% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $68.95median of 72 rows · $55.28–$105.60 | $82.68 | 83% | not typically billed by clinical social workers | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $108.08median of 2 rows · $108.08–$108.08 | $138.62 | 78% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $122.70median of 76 rows · $92.58–$185.26 | $138.62 | 89% | 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 Beth Emmons, MSW, LICSW performs these services, and they are kept out of the benchmark above.