Carol Orsak, MA
Audiologist-Hearing Aid Fitter · Houston, TX 77082 · NPI 1710134317 · 1 payer file
71%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Carol Orsak, MA $68.42 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 60 contract rows for this clinician and code, from $53.95 to $81.60; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston audiologist-hearing aid fitters, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $68.42median of 60 rows · $53.95–$81.60 | $96.33 | 71% | above 15% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $99.31median of 50 rows · $79.48–$118.37 | $137.41 | 72% | above 17% 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 audiologist-hearing aid fitters, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 36 rows · $57.93–$78.30 | $82.68 | 79% | not typically billed by audiologist-hearing aid fitters |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.60median of 30 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by audiologist-hearing aid fitters |
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 Carol Orsak, MA performs these services, and they are kept out of the benchmark above.