Carmen Esther Rivera, CSW
Clinical Social Worker · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 4
- 1 carrier
- Office
- 1
Offices
1 location · County of Santa Clara · 1,000 clinicians in this group
Plans that list them
4 plans · 1 carrier
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Carmen Esther Rivera’s office at (408) 885-5000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
| SCAN Balance (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Classic (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN MyChoice (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Strive (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
Original Medicare doctor bills
$6,283
Medicare paid this office $6,283 for 17 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Psychotherapy, 1 hour | 12 | $3,368 | $89 |
Who their Medicare patients are
17 Original Medicare patients in 2024. Average age 58 · Also on Medicaid 100% · Health risk score 1.58. Above the middle of the specialty; the typical licensed clinical social worker clinician is at 1.22.
Conditions among them: Depression 75%.
The office billed $58,147, Medicare allowed $7,871 and paid $6,283; for 84 services of 4 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 17 | 84 | 58 | 1.58 | $58,147 | $6,283 |
| 2023 | 16 | 67 | 58 | 1.53 | $37,891 | $3,791 |
| 2022 | 14 | 99 | 60 | 1.48 | $52,839 | $5,739 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 1 service
| Psychotherapy, 45 minutes | 11 | $1,043 | $50 |
Medicaid work
$1,959 in 2023
Medicaid paid $1,959 for 226 billed services this clinician did in 2023, up to 18 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| Psychotherapy, 60 minutes with patient | 119 | $1,113 |
| PSYCHOTHERAPY W/PATIENT 30 MINUTES | 71 | $654 |
| PSYCH DIAGNOSTIC EVALUATION | 12 | $101 |
| Psychotherapy, 45 minutes with patient | 24 | $91 |
| 2023 | 226 | 4 | 18 | $1,959 |
| 2022 | 134 | 2 | 22 | $682 |
| 2021 | 85 | 1 | 15 | $1,379 |
| 2019 | 40 | 1 | 12 | $1,802 |
See the largest Medicaid services in earlier years
2022
| Psychotherapy, 45 minutes with patient | 117 | $546 |
| Psychotherapy, 60 minutes with patient | 17 | $136 |
2021
| Psychotherapy, 45 minutes with patient | 85 | $1,379 |
2019
| Psychotherapy, 60 minutes with patient | 40 | $1,802 |
Checkups this office reported
Medicare did not publish checkup rates for this clinician.
- Medicare’s overall office score
- 80.6 / 100
- Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.
Professional record
- NPI
- 1679764203
- Video visits
- Lists video visits
- Gender
- Female
More record details
- Sole proprietor
- No
- Taxonomy
- Federal specialty code 101Y00000X (101Y00000X)
- Mailing address
- 160 E Virginia St, Ste 280, San Jose, CA, 95112
- NPI first listed
- 2007-08-08
- NPI last updated
- 2007-08-08
This is when the NPI record was last certified, not a medical board exam.