Samual Todd, MD
Surgical Critical Care Physician · Houston, TX 77030 · NPI 1104858281 · 1 payer file
75%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Samual Todd, MD $72.25 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 60 contract rows for this clinician and code, from $53.12 to $322.53; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical critical care physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $72.25median of 60 rows · $53.12–$322.53 | $96.33 | 75% | above 5% of 20 Houston surgical critical care physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $102.53median of 60 rows · $76.90–$474.07 | $137.41 | 75% | above 5% of 20 Houston surgical critical care physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston surgical critical care physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $68.95median of 12 rows · $60.83–$81.11 | $82.68 | 83% | not typically billed by surgical critical care physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $116.29median of 12 rows · $102.61–$136.81 | $138.62 | 84% | not typically billed by surgical critical care 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 Samual Todd, MD performs these services, and they are kept out of the benchmark above.