Amanda Cherry, LCSW
Clinical Social Worker · Houston, TX 77002 · NPI 1780198937 · 1 payer file
83%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Amanda Cherry, LCSW $79.81 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 132 contract rows for this clinician and code, from $41.32 to $107.53; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $79.81median of 132 rows · $41.32–$107.53 | $96.33 | 83% | above 94% of 780 Houston clinical social workers on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $115.59median of 106 rows · $63.67–$155.56 | $137.41 | 84% | above 94% of 783 Houston clinical social workers on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical social workers, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $80.54median of 44 rows · $64.00–$101.43 | $82.68 | 97% | not typically billed by clinical social workers |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $132.71median of 36 rows · $103.50–$168.87 | $138.62 | 96% | not typically billed by clinical social workers |
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 Amanda Cherry, LCSW performs these services, and they are kept out of the benchmark above.