Jillian Schmitt, P.T.
Physical Therapist · Houston, TX 77058 · NPI 1952563314 · 1 payer file
59%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Jillian Schmitt, P.T. $56.88 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 24 contract rows for this clinician and code, from $42.18 to $76.68; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physical therapists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $56.88median of 24 rows · $42.18–$76.68 | $96.33 | 59% | above 5% of 104 Houston physical therapists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $82.06median of 24 rows · $62.15–$108.35 | $137.41 | 60% | above 5% of 106 Houston physical therapists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physical therapists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $59.43median of 24 rows · $49.49–$73.84 | $82.68 | 72% | not typically billed by physical therapists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $100.12median of 24 rows · $83.53–$124.22 | $138.62 | 72% | not typically billed by physical therapists |
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 Jillian Schmitt, P.T. performs these services, and they are kept out of the benchmark above.