Sarah Nelin, MD
Neonatal-Perinatal Medicine Physician · Houston, TX 77030 · NPI 1356735948 · 1 payer file
65%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Sarah Nelin, MD $62.59 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 48 contract rows for this clinician and code, from $46.54 to $84.19; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neonatal-perinatal medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $62.59median of 48 rows · $46.54–$84.19 | $96.33 | 65% | above 0% of 159 Houston neonatal-perinatal medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $90.28median of 48 rows · $68.53–$118.90 | $137.41 | 66% | above 0% of 160 Houston neonatal-perinatal medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neonatal-perinatal medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $73.06median of 24 rows · $60.97–$90.61 | $82.68 | 88% | not typically billed by neonatal-perinatal medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $123.44median of 24 rows · $103.27–$152.74 | $138.62 | 89% | not typically billed by neonatal-perinatal medicine physicians |
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 Sarah Nelin, MD performs these services, and they are kept out of the benchmark above.