Joohi Jimenez-shahed, M.D.
Neurology Physician · Houston, TX 77030 · NPI 1033299623 · 1 payer file
173%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Joohi Jimenez-shahed, M.D. $166.50 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 $141.00 to $192.00; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $166.50median of 8 rows · $141.00–$192.00 | $96.33 | 173% | above 93% of 189 Houston neurology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $230.00median of 8 rows · $197.00–$263.00 | $137.41 | 167% | above 93% of 189 Houston neurology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $178.00median of 4 rows · $178.00–$178.00 | $82.68 | 215% | not typically billed by neurology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $351.00median of 4 rows · $351.00–$351.00 | $138.62 | 253% | not typically billed by neurology 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 Joohi Jimenez-shahed, M.D. performs these services, and they are kept out of the benchmark above.