Donna Edwards, PMH- NP
Psychiatric/Mental Health Nurse Practitioner · Houston, TX 77024 · NPI 1871629840 · 2 payer files
56%of Medicare
Cigna — Texas Connect (individual & family) pays Donna Edwards, PMH- NP $53.79 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 2 contract rows for this clinician and code, from $53.79 to $53.79; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychiatric/mental health nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $53.79median of 2 rows · $53.79–$53.79 | $96.33 | 56% | above 17% of 283 Houston psychiatric/mental health nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $77.20median of 2 rows · $77.20–$77.20 | $96.33 | 80% | above 2% of 122 Houston psychiatric/mental health nurse practitioners on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $84.39median of 2 rows · $84.39–$84.39 | $137.41 | 61% | above 17% of 283 Houston psychiatric/mental health nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $109.17median of 2 rows · $109.17–$109.17 | $137.41 | 79% | above 2% of 122 Houston psychiatric/mental health nurse practitioners on this plan | |
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $38.00median of 2 rows · $38.00–$38.00 | $82.68 | 46% | above 0% of 283 Houston psychiatric/mental health nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $64.63median of 2 rows · $64.63–$64.63 | $82.68 | 78% | above 2% of 122 Houston psychiatric/mental health nurse practitioners on this plan | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $101.00median of 2 rows · $101.00–$101.00 | $138.62 | 73% | above 0% of 283 Houston psychiatric/mental health nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $99.08median of 2 rows · $99.08–$99.08 | $138.62 | 71% | above 2% of 122 Houston psychiatric/mental health nurse practitioners on this plan |