Amanda Zold, PHD
Clinical Psychologist · Houston, TX 77021 · NPI 1265734826 · 2 payer files
116%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Amanda Zold, PHD $111.62 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 12 contract rows for this clinician and code, from $80.98 to $118.30; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical psychologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $111.62median of 12 rows · $80.98–$118.30 | $96.33 | 116% | above 90% of 169 Houston clinical psychologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $139.03median of 12 rows · $119.77–$158.28 | $137.41 | 101% | above 88% of 170 Houston clinical psychologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical psychologists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $72.57median of 2 rows · $64.63–$80.51 | $82.68 | 88% | not typically billed by clinical psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $93.00median of 8 rows · $79.71–$106.28 | $82.68 | 112% | not typically billed by clinical psychologists | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $125.24median of 2 rows · $116.57–$133.91 | $138.62 | 90% | not typically billed by clinical psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $173.96median of 8 rows · $149.11–$198.81 | $138.62 | 125% | not typically billed by clinical 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 Amanda Zold, PHD performs these services, and they are kept out of the benchmark above.