Helena Patten, M.D.
Dermatology Physician · Houston, TX 77007 · NPI 1073049599
84%of Medicare
BCBSTX pays Helena Patten, M.D. $80.69 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 dermatology physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $80.69 | $96.33 | 84% | above 74% of 118 Houston dermatology physicians |
| 99214Office visit, established patient, moderate complexity | $118.20 | $137.41 | 86% | above 75% of 118 Houston dermatology physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by dermatology 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 Helena Patten, M.D. performs these services, and they are kept out of the benchmark above.