Adeola Franks, M.A. CCC-SLP
Speech-Language Pathologist · Houston, TX 77042 · NPI 1275839607 · 1 payer file
55%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Adeola Franks, M.A. CCC-SLP $53.43 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 60 contract rows for this clinician and code, from $37.82 to $73.38; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston speech-language pathologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $53.43median of 60 rows · $37.82–$73.38 | $96.33 | 55% | above 4% of 80 Houston speech-language pathologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $80.20median of 60 rows · $58.34–$107.83 | $137.41 | 58% | above 3% of 80 Houston speech-language pathologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston speech-language pathologists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $53.42median of 48 rows · $42.39–$68.95 | $82.68 | 65% | not typically billed by speech-language pathologists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $89.78median of 48 rows · $71.43–$115.64 | $138.62 | 65% | not typically billed by speech-language pathologists |
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 Adeola Franks, M.A. CCC-SLP performs these services, and they are kept out of the benchmark above.