Isabelle Francois, M.A.
Speech-Language Pathologist · Houston, TX 77015 · NPI 1336875327 · 1 payer file
60%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Isabelle Francois, M.A. $57.80 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 32 contract rows for this clinician and code, from $53.12 to $72.25; 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) | $57.80median of 32 rows · $53.12–$72.25 | $96.33 | 60% | above 6% of 80 Houston speech-language pathologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $82.81median of 32 rows · $76.90–$102.53 | $137.41 | 60% | above 5% 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) | $68.95median of 12 rows · $60.83–$81.11 | $82.68 | 83% | not typically billed by speech-language pathologists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $116.29median of 12 rows · $102.61–$136.81 | $138.62 | 84% | 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 Isabelle Francois, M.A. performs these services, and they are kept out of the benchmark above.