Ashlee Byrnes, MSGENETIC COUNSELING
Genetic Counselor (M.S.) · Houston, TX 77030 · NPI 1770142721 · 1 payer file
101%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Ashlee Byrnes, MSGENETIC COUNSELING $97.66 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 12 contract rows for this clinician and code, from $82.49 to $112.84; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston genetic counselor (m.s.)s, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.66median of 12 rows · $82.49–$112.84 | $96.33 | 101% | above 90% of 21 Houston genetic counselor (m.s.)s on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $140.32median of 8 rows · $121.45–$159.20 | $137.41 | 102% | above 90% of 21 Houston genetic counselor (m.s.)s on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston genetic counselor (m.s.)s, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $90.08median of 8 rows · $85.02–$95.14 | $82.68 | 109% | not typically billed by genetic counselor (m.s.)s |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $152.28median of 8 rows · $144.11–$160.44 | $138.62 | 110% | not typically billed by genetic counselor (m.s.)s |
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 Ashlee Byrnes, MSGENETIC COUNSELING performs these services, and they are kept out of the benchmark above.