AYA Itani, MD, MPH
Emergency Medicine Physician · Houston, TX 77030 · NPI 1043706971 · 1 payer file
70%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays AYA Itani, MD, MPH $67.79 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 20 contract rows for this clinician and code, from $39.90 to $90.39; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston emergency medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $67.79median of 20 rows · $39.90–$90.39 | $96.33 | 70% | above 6% of 402 Houston emergency medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.85median of 30 rows · $54.00–$130.47 | $137.41 | 71% | above 6% of 415 Houston emergency medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston emergency medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $79.63median of 12 rows · $70.26–$93.68 | $82.68 | 96% | not typically billed by emergency medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $134.66median of 12 rows · $118.82–$158.42 | $138.62 | 97% | not typically billed by 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 AYA Itani, MD, MPH performs these services, and they are kept out of the benchmark above.