James Prevost, PA
Physician Assistant · Houston, TX 77074 · NPI 1851885032 · 1 payer file
69%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays James Prevost, PA $66.28 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 32 contract rows for this clinician and code, from $44.00 to $187.09; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $66.28median of 32 rows · $44.00–$187.09 | $96.33 | 69% | above 21% of 1,220 Houston physician assistants on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $93.13median of 32 rows · $64.76–$263.61 | $137.41 | 68% | above 16% of 1,217 Houston physician assistants on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $63.84median of 32 rows · $48.71–$146.53 | $82.68 | 77% | not typically billed by 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 James Prevost, PA performs these services, and they are kept out of the benchmark above.