Breyaun Bennett
Social Worker · Houston, TX 77007 · NPI 1578295721 · 1 payer file
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Breyaun Bennett $69.06 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. The file lists 60 contract rows for this clinician and code, from $53.61 to $81.60; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $69.06median of 60 rows · $53.61–$81.60 | $96.33 | 72% | above 16% of 69 Houston social workers on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.10median of 60 rows · $78.99–$118.37 | $137.41 | 73% | above 49% of 69 Houston social workers on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston social workers, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.21median of 24 rows · $58.12–$78.30 | $82.68 | 80% | not typically billed by social workers |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $116.06median of 24 rows · $102.01–$137.08 | $138.62 | 84% | not typically billed by 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 Breyaun Bennett performs these services, and they are kept out of the benchmark above.