AMY Acosta, PHD
Psychologist · Houston, TX 77030 · NPI 1265720700 · 2 payer files
56%of Medicare
Cigna — Texas Connect (individual & family) pays AMY Acosta, PHD $53.79 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 $53.79 to $53.79; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $53.79median of 2 rows · $53.79–$53.79 | $96.33 | 56% | above 6% of 54 Houston psychologists on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 10 rows · $55.30–$81.60 | $96.33 | 72% | above 45% of 120 Houston psychologists on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $84.39median of 2 rows · $84.39–$84.39 | $137.41 | 61% | above 6% of 54 Houston psychologists on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 10 rows · $81.21–$118.37 | $137.41 | 73% | above 55% of 120 Houston psychologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychologists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $28.00median of 2 rows · $28.00–$28.00 | $82.68 | 34% | not typically billed by psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 6 rows · $58.73–$78.30 | $82.68 | 81% | not typically billed by psychologists | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $75.00median of 2 rows · $75.00–$75.00 | $138.62 | 54% | not typically billed by psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 6 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by psychologists |
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 AMY Acosta, PHD performs these services, and they are kept out of the benchmark above.