William Cook, ARNP
Pediatric Nurse Practitioner · Houston, TX 77030 · NPI 1669490751 · 1 payer file
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays William Cook, ARNP $69.35 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 20 contract rows for this clinician and code, from $55.29 to $81.59; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $69.35median of 20 rows · $55.29–$81.59 | $96.33 | 72% | above 17% of 222 Houston pediatric nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.60median of 20 rows · $81.20–$118.37 | $137.41 | 73% | above 17% of 221 Houston pediatric nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.72–$78.29 | $82.68 | 81% | not typically billed by pediatric nurse practitioners |
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 William Cook, ARNP performs these services, and they are kept out of the benchmark above.