Tiffany Dugas, MD
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician · Houston, TX 77027 · NPI 1023405677
112%of Medicare
BCBSTX pays Tiffany Dugas, MD $108.04 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston undersea and hyperbaric medicine (emergency medicine) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $108.04 | $96.33 | 112% | above 80% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 26% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $552.24 | $317.92 | 174% | not typically billed by undersea and hyperbaric medicine (emergency medicine) physicians |
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by undersea and hyperbaric medicine (emergency medicine) physicians |
| 74177CT abdomen and pelvis, with contrast | $1,527.58 | $300.72 | 508% | not typically billed by undersea and hyperbaric medicine (emergency medicine) physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by undersea and hyperbaric medicine (emergency medicine) physicians |
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 Tiffany Dugas, MD performs these services, and they are kept out of the benchmark above.