Glen Hilton, MS, LMFT
Marriage & Family Therapist · Houston, TX 77092 · NPI 1588836928 · 1 payer file
66%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Glen Hilton, MS, LMFT $63.91 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 80 contract rows for this clinician and code, from $40.34 to $83.73; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston marriage & family therapists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $63.91median of 80 rows · $40.34–$83.73 | $96.33 | 66% | above 8% of 144 Houston marriage & family therapists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $94.50median of 80 rows · $62.14–$121.10 | $137.41 | 69% | above 10% of 144 Houston marriage & family therapists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston marriage & family therapists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $72.25median of 30 rows · $58.73–$85.00 | $82.68 | 87% | not typically billed by marriage & family therapists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $117.30median of 30 rows · $102.01–$138.00 | $138.62 | 85% | not typically billed by marriage & family therapists |
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 Glen Hilton, MS, LMFT performs these services, and they are kept out of the benchmark above.