James Fontenot, M.D.
General Practice Physician · Houston, TX 77090 · NPI 1063511640 · 1 payer file
77%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays James Fontenot, M.D. $74.21 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 $59.17 to $87.31; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston general practice physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $74.21median of 20 rows · $59.17–$87.31 | $96.33 | 77% | above 56% of 42 Houston general practice physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $107.65median of 20 rows · $86.89–$126.65 | $137.41 | 78% | above 60% of 43 Houston general practice physicians on this plan |