Heather Thompson, D.C.
Chiropractor · Houston, TX 77034 · NPI 1275980781 · 1 payer file
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Heather Thompson, D.C. $69.35 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 38 contract rows for this clinician and code, from $55.29 to $81.59; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston chiropractors, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $69.35median of 38 rows · $55.29–$81.59 | $96.33 | 72% | above 61% of 134 Houston chiropractors on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.60median of 40 rows · $81.20–$118.37 | $137.41 | 73% | above 66% of 115 Houston chiropractors on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston chiropractors, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 18 rows · $58.72–$78.29 | $82.68 | 81% | not typically billed by chiropractors |
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 Heather Thompson, D.C. performs these services, and they are kept out of the benchmark above.