Arsalah Bana, OD
Optometrist · Houston, TX 77042 · NPI 1023689742 · 1 payer file
63%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Arsalah Bana, OD $61.06 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 496 contract rows for this clinician and code, from $40.81 to $86.32; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston optometrists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $61.06median of 496 rows · $40.81–$86.32 | $96.33 | 63% | above 66% of 575 Houston optometrists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $90.03median of 490 rows · $61.68–$127.41 | $137.41 | 66% | above 63% of 575 Houston optometrists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston optometrists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 80 rows · $56.65–$78.30 | $82.68 | 79% | not typically billed by optometrists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $105.72median of 60 rows · $79.29–$137.08 | $138.62 | 76% | not typically billed by optometrists |
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 Arsalah Bana, OD performs these services, and they are kept out of the benchmark above.