Paul Cinciripini, PH.D.
Addiction (Substance Use Disorder) Psychologist · Houston, TX 77030 · NPI 1568558294
134%of Medicare
BCBSTX pays Paul Cinciripini, PH.D. $129.07 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 addiction (substance use disorder) psychologists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $129.07 | $96.33 | 134% | above 84% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $189.08 | $137.41 | 138% | above 90% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $186.80 | $126.38 | 148% | not typically billed by addiction (substance use disorder) 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 Paul Cinciripini, PH.D. performs these services, and they are kept out of the benchmark above.