Mary Mcfarland-norris, LCSW
Clinical Social Worker · Houston, TX 77004 · NPI 1568746238 · 1 payer file
78%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Mary Mcfarland-norris, LCSW $74.68 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 128 contract rows for this clinician and code, from $50.20 to $95.45; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $74.68median of 128 rows · $50.20–$95.45 | $96.33 | 78% | above 91% of 780 Houston clinical social workers on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $106.66median of 64 rows · $73.73–$138.08 | $137.41 | 78% | above 92% of 783 Houston clinical social workers on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $67.38median of 48 rows · $48.89–$90.03 | $82.68 | 81% | not typically billed by clinical social workers |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $112.63median of 84 rows · $81.65–$149.90 | $138.62 | 81% | not typically billed by clinical social workers |
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 Mary Mcfarland-norris, LCSW performs these services, and they are kept out of the benchmark above.