Brenda Sprinkle, PH.D.
Clinical Psychologist · Houston, TX 77024 · NPI 1568499366
67%of Medicare
BCBSTX pays Brenda Sprinkle, PH.D. $64.09 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 | BCBSTX | Medicare | % of Medicare | Among Houston clinical psychologists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $64.09 | $96.33 | 67% | above 81% of 197 Houston clinical psychologists |
| 99214Office visit, established patient, moderate complexity | $93.89 | $137.41 | 68% | above 8% of 197 Houston clinical psychologists |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $27.87 | $126.38 | 22% | not typically billed by clinical psychologists |
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 Brenda Sprinkle, PH.D. performs these services, and they are kept out of the benchmark above.