Georgiana Mcnamara, NP
Acute Care Nurse Practitioner · Houston, TX 77036 · NPI 1902521388 · 1 payer file
74%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Georgiana Mcnamara, NP $71.07 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 60 contract rows for this clinician and code, from $39.90 to $110.33; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston acute care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $71.07median of 60 rows · $39.90–$110.33 | $96.33 | 74% | above 73% of 469 Houston acute care nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $102.20median of 70 rows · $54.00–$161.01 | $137.41 | 74% | above 73% of 468 Houston acute care nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston acute care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $76.44median of 36 rows · $57.33–$99.91 | $82.68 | 92% | not typically billed by acute care nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $127.59median of 36 rows · $95.69–$166.92 | $138.62 | 92% | not typically billed by acute care 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 Georgiana Mcnamara, NP performs these services, and they are kept out of the benchmark above.
