Bridget Pepe, PA-C
Physician Assistant · Houston, TX 77030 · NPI 1487297974 · 2 payer files
84%of Medicare
UnitedHealthcare — Optum Behavioral Health pays Bridget Pepe, PA-C $81.06 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.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | UnitedHealthcare — Optum Behavioral Health | $81.06 | $96.33 | 84% | above 94% of 19 Houston physician assistants on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $38.98median of 32 rows · $28.37–$53.50 | $96.33 | 40% | above 0% of 1,220 Houston physician assistants on this plan | |
| 99214Office visit, established patient, moderate complexity | UnitedHealthcare — Optum Behavioral Health | $114.62 | $137.41 | 83% | above 94% of 19 Houston physician assistants on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $54.03median of 36 rows · $39.93–$73.09 | $137.41 | 39% | above 0% of 1,217 Houston physician assistants on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $67.86 | $82.68 | 82% | not typically billed by physician assistants |
| Aetna — Texas (office visit and psychotherapy codes only) | $64.55median of 24 rows · $53.40–$80.67 | $82.68 | 78% | not typically billed by physician assistants | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $104.04 | $138.62 | 75% | not typically billed by physician assistants |
| Aetna — Texas (office visit and psychotherapy codes only) | $108.50median of 24 rows · $89.93–$135.38 | $138.62 | 78% | not typically billed by physician assistants |
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 Bridget Pepe, PA-C performs these services, and they are kept out of the benchmark above.