Rhonda Kaplan, PHD
Psychologist · Houston, TX 77024 · NPI 1841373628 · 2 payer files
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Rhonda Kaplan, PHD $69.36 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 40 contract rows for this clinician and code, from $55.30 to $81.60; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychologists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 40 rows · $55.30–$81.60 | $96.33 | 72% | above 45% of 120 Houston psychologists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 40 rows · $81.21–$118.37 | $137.41 | 73% | above 55% of 120 Houston psychologists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston 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 psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.73–$78.30 | $82.68 | 81% | not typically billed by psychologists | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $116.57 | $138.62 | 84% | not typically billed by psychologists |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 12 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by 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 Rhonda Kaplan, PHD performs these services, and they are kept out of the benchmark above.