Aetna (CVS Health) NP rates in Pennsylvania
Aetna (CVS Health) lists a typical $93.66 for a solo NP practice's 99214 in Pennsylvania, across 254 billing groups. The middle half of groups list $93.66–$99.99. That is 14% below the typical rate across all Pennsylvania insurers ($109.17).
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| Visit | Solo NP practice | NP-only group | NP + physician group | Large organization | Medicare | Medicaid |
|---|---|---|---|---|---|---|
| 99214 Follow-up visit, moderate | $93.66 | $93.66 | $93.66 | $99.91 | $110.39–$119.34 | $54.42 |
| 99213 Follow-up visit, simpler | $64.45 | $64.45 | $64.45 | $69.33 | $77.38–$83.77 | $35.00 |
| 99215 Follow-up visit, complex | $125.99 | $125.99 | $125.99 | $136.47 | $156.80–$169.31 | $78.05 |
| 99204 New patient visit | $131.43 | $131.43 | $131.43 | $136.70 | $144.63–$156.27 | $90.37 |
| 99205 New patient visit, complex | $172.83 | $173.91 | $173.91 | $174.06 | $193.21–$208.81 | $117.54 |
| 90792 Psychiatric intake (evaluation) | $145.23 | $145.23 | $145.23 | $145.23 | $167.49–$176.83 | — |
| 90833 Therapy add-on, 30 min | $65.65 | $65.65 | $65.65 | $65.65 | $67.63–$71.30 | — |
| 90836 Therapy add-on, 45 min | $85.67 | $88.24 | $88.23 | $88.24 | — | — |
| 90837 Therapy, 60 min | $127.33 | $127.33 | $127.33 | $127.33 | — | — |
| G2211 Ongoing-care add-on | — | — | $18.34 | $18.64 | $14.34–$15.24 | — |
Typical listed rate per visit: the middle of each insurer’s typical rate, one vote per insurer; cells need 5+ groups. Solo NP, Medicare and Medicaid are always open; other practice types open free with name + email.
NP-owned vs physician-led billing · 99214
NP-owned groups: $93.66 (381 groups) · Physician-led groups: $93.66 (708)
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Other insurers in Pennsylvania: Ambetter · Cigna · Highmark · Independence Blue Cross · Optum Behavioral Health · Oscar Health · UnitedHealthcare · UPMC Health Plan. Back to Pennsylvania.