Renee Lopez, LSA
Surgical Assistant · Houston, TX 77044 · NPI 1669782330 · 1 payer file
53%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Renee Lopez, LSA $51.33 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 48 contract rows for this clinician and code, from $37.67 to $69.91; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $51.33median of 48 rows · $37.67–$69.91 | $96.33 | 53% | above 0% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $73.87median of 48 rows · $55.46–$98.41 | $137.41 | 54% | above 0% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $51.98median of 24 rows · $43.10–$64.85 | $82.68 | 63% | not typically billed by surgical assistants |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $87.92median of 24 rows · $73.11–$109.40 | $138.62 | 63% | not typically billed by surgical assistants |
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 Renee Lopez, LSA performs these services, and they are kept out of the benchmark above.