Jessica Ellsworth, AU.D.
Audiologist · Houston, TX 77058 · NPI 1205426483 · 1 payer file
67%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Jessica Ellsworth, AU.D. $64.39 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 56 contract rows for this clinician and code, from $51.18 to $80.50; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston audiologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $64.39median of 56 rows · $51.18–$80.50 | $96.33 | 67% | above 26% of 59 Houston audiologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $89.45median of 46 rows · $78.70–$116.82 | $137.41 | 65% | above 2% of 58 Houston audiologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston audiologists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 24 rows · $57.93–$77.26 | $82.68 | 79% | not typically billed by audiologists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.60median of 18 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by audiologists |
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 Jessica Ellsworth, AU.D. performs these services, and they are kept out of the benchmark above.