Joannis Baez Gonzalez, MD
Hospice and Palliative Medicine (Internal Medicine) Physician · Houston, TX 77030 · NPI 1043730294 · 1 payer file
80%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Joannis Baez Gonzalez, MD $76.82 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 36 contract rows for this clinician and code, from $39.89 to $162.50; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospice and palliative medicine (internal medicine) physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $76.82median of 36 rows · $39.89–$162.50 | $96.33 | 80% | above 18% of 39 Houston hospice and palliative medicine (internal medicine) physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $110.90median of 36 rows · $54.00–$229.07 | $137.41 | 81% | above 18% of 39 Houston hospice and palliative medicine (internal medicine) physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospice and palliative medicine (internal medicine) physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $81.98median of 8 rows · $72.65–$91.31 | $82.68 | 99% | not typically billed by hospice and palliative medicine (internal medicine) physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $137.47median of 8 rows · $121.79–$153.16 | $138.62 | 99% | not typically billed by hospice and palliative medicine (internal 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 Joannis Baez Gonzalez, MD performs these services, and they are kept out of the benchmark above.