Brian Odhiambo, PMHNP-BC
Psychiatric/Mental Health Registered Nurse · Houston, TX 77030 · NPI 1912876970 · 1 payer file
116%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Brian Odhiambo, PMHNP-BC $111.62 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 12 contract rows for this clinician and code, from $80.98 to $118.30; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychiatric/mental health registered nurses, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $111.62median of 12 rows · $80.98–$118.30 | $96.33 | 116% | above 79% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $139.03median of 12 rows · $119.77–$158.28 | $137.41 | 101% | above 61% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychiatric/mental health registered nurses, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $93.00median of 8 rows · $79.71–$106.28 | $82.68 | 112% | not typically billed by psychiatric/mental health registered nurses |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $173.96median of 8 rows · $149.11–$198.81 | $138.62 | 125% | not typically billed by psychiatric/mental health registered nurses |
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 Brian Odhiambo, PMHNP-BC performs these services, and they are kept out of the benchmark above.