ROY Zhang, MD
Neurology Physician · Houston, TX 77030 · NPI 1073959516 · 1 payer file
64%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays ROY Zhang, MD $61.52 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 32 contract rows for this clinician and code, from $41.43 to $176.77; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $61.52median of 32 rows · $41.43–$176.77 | $96.33 | 64% | above 5% of 189 Houston neurology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $86.67median of 32 rows · $61.00–$249.46 | $137.41 | 63% | above 2% of 189 Houston neurology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $61.92median of 32 rows · $47.41–$140.83 | $82.68 | 75% | not typically billed by neurology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $104.75median of 32 rows · $80.42–$236.07 | $138.62 | 76% | not typically billed by neurology 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 ROY Zhang, MD performs these services, and they are kept out of the benchmark above.