Cheryl Bowman, LPC
Professional Counselor · Houston, TX 77061 · NPI 1376973370 · 1 payer file
82%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Cheryl Bowman, LPC $79.41 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 28 contract rows for this clinician and code, from $61.65 to $93.42; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston professional counselors, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $79.41median of 28 rows · $61.65–$93.42 | $96.33 | 82% | above 97% of 1,205 Houston professional counselors on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $115.11median of 20 rows · $90.83–$135.42 | $137.41 | 84% | above 97% of 1,207 Houston professional counselors on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston professional counselors, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $75.73median of 18 rows · $66.83–$89.11 | $82.68 | 92% | not typically billed by professional counselors |
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 Cheryl Bowman, LPC performs these services, and they are kept out of the benchmark above.