Mary Walsh
Surgical Physician Assistant · Houston, TX 77030 · NPI 1700619319 · 1 payer file
65%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Mary Walsh $62.42 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 $49.76 to $73.43; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical physician assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $62.42median of 20 rows · $49.76–$73.43 | $96.33 | 65% | above 10% of 144 Houston surgical physician assistants on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $90.54median of 20 rows · $73.08–$106.53 | $137.41 | 66% | above 6% of 144 Houston surgical physician assistants on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical physician assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $59.90median of 12 rows · $52.85–$70.46 | $82.68 | 72% | not typically billed by surgical physician 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 Mary Walsh performs these services, and they are kept out of the benchmark above.