IAN Folkert, MD
Surgery Physician · Houston, TX 77030 · NPI 1023453875 · 1 payer file
119%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays IAN Folkert, MD $114.28 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 8 contract rows for this clinician and code, from $91.55 to $137.00; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $114.28median of 8 rows · $91.55–$137.00 | $96.33 | 119% | above 73% of 230 Houston surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $182.50median of 8 rows · $151.00–$214.00 | $137.41 | 133% | above 76% of 230 Houston surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $192.96median of 12 rows · $170.27–$227.02 | $82.68 | 233% | not typically billed by surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $322.09median of 12 rows · $284.19–$378.94 | $138.62 | 232% | not typically billed by surgery 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 IAN Folkert, MD performs these services, and they are kept out of the benchmark above.