Alexandra Sanfilippo, PA-C
Medical Physician Assistant · Houston, TX 77030 · NPI 1750931499 · 1 payer file
73%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Alexandra Sanfilippo, PA-C $70.70 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 56 contract rows for this clinician and code, from $39.89 to $252.20; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston medical physician assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $70.70median of 56 rows · $39.89–$252.20 | $96.33 | 73% | above 82% of 129 Houston medical physician assistants on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.84median of 66 rows · $54.00–$353.95 | $137.41 | 71% | above 37% of 128 Houston medical physician assistants on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston medical physician assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $92.35median of 24 rows · $52.85–$129.10 | $82.68 | 112% | not typically billed by medical physician assistants |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $202.63median of 8 rows · $190.81–$214.45 | $138.62 | 146% | not typically billed by medical 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 Alexandra Sanfilippo, PA-C performs these services, and they are kept out of the benchmark above.