Tony CAO, PSYD
Psychiatry Physician · Houston, TX 77094 · NPI 1063077014
46%of Medicare
BCBSTX pays Tony CAO, PSYD $44.20 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston psychiatry physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $44.20 | $96.33 | 46% | above 1% of 357 Houston psychiatry physicians |
| 99214Office visit, established patient, moderate complexity | $94.02 | $137.41 | 68% | above 23% of 357 Houston psychiatry physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $25.17 | $126.38 | 20% | not typically billed by psychiatry 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 Tony CAO, PSYD performs these services, and they are kept out of the benchmark above.