Sharon Walker, PH.D
Clinical Psychologist · Houston, TX 77098 · NPI 1730120296 · 2 payer files
74%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Sharon Walker, PH.D $71.58 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 154 contract rows for this clinician and code, from $50.20 to $109.93; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical psychologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $71.58median of 154 rows · $50.20–$109.93 | $96.33 | 74% | above 68% of 169 Houston clinical psychologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $102.53median of 188 rows · $73.73–$159.65 | $137.41 | 75% | above 78% of 170 Houston clinical psychologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical psychologists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $64.63 | $82.68 | 78% | not typically billed by clinical psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $68.95median of 108 rows · $48.89–$105.60 | $82.68 | 83% | not typically billed by clinical psychologists | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $116.57 | $138.62 | 84% | not typically billed by clinical psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 140 rows · $81.65–$185.26 | $138.62 | 83% | not typically billed by clinical psychologists |
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 Sharon Walker, PH.D performs these services, and they are kept out of the benchmark above.