Michelle Argentina
Clinical Social Worker · Houston, TX 77008 · NPI 1649938705 · 2 payer files
112%of Medicare
Cigna — Texas Connect (individual & family) pays Michelle Argentina $107.97 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 | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $107.97 | $96.33 | 112% | above 2% of 41 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $72.25median of 90 rows · $53.11–$109.93 | $96.33 | 75% | above 52% of 780 Houston clinical social workers on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $156.34 | $137.41 | 114% | above 2% of 41 Houston clinical social workers on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $94.84median of 80 rows · $76.90–$159.65 | $137.41 | 69% | above 13% 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 | Cigna — Texas Connect (individual & family) | $94.48 | $82.68 | 114% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $75.03median of 60 rows · $55.28–$105.60 | $82.68 | 91% | not typically billed by clinical social workers | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $152.97 | $138.62 | 110% | not typically billed by clinical social workers |
| Aetna — Texas (office visit and psychotherapy codes only) | $122.70median of 56 rows · $92.58–$185.26 | $138.62 | 89% | 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 Michelle Argentina performs these services, and they are kept out of the benchmark above.