Ruby Varkey, APRN
Family Nurse Practitioner · Houston, TX 77030 · NPI 1851951222 · 1 payer file
72%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Ruby Varkey, APRN $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 30 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 family nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 30 rows · $55.30–$81.60 | $96.33 | 72% | above 55% of 1,439 Houston family nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 30 rows · $81.21–$118.37 | $137.41 | 73% | above 54% of 1,443 Houston family nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.73–$78.30 | $82.68 | 81% | not typically billed by family nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 12 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by family nurse practitioners |
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 Ruby Varkey, APRN performs these services, and they are kept out of the benchmark above.