Anne Boatwright, LICSW
Clinical Social Worker · Houston, TX 77090 · NPI 1275334773 · 1 payer file
75%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Anne Boatwright, LICSW $72.25 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 126 contract rows for this clinician and code, from $50.20 to $109.93; 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 | Aetna — Texas (office visit and psychotherapy codes only) | $72.25median of 126 rows · $50.20–$109.93 | $96.33 | 75% | above 52% of 780 Houston clinical social workers on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $103.56median of 182 rows · $73.73–$159.65 | $137.41 | 75% | above 83% 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 | Aetna — Texas (office visit and psychotherapy codes only) | $68.95median of 100 rows · $48.89–$105.60 | $82.68 | 83% | not typically billed by clinical social workers |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $116.29median of 152 rows · $81.65–$185.26 | $138.62 | 84% | 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 Anne Boatwright, LICSW performs these services, and they are kept out of the benchmark above.