Seon Kyung NAM, MD
Neurology Physician · Houston, TX 77030 · NPI 1124608781 · 1 payer file
66%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Seon Kyung NAM, MD $63.91 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 30 contract rows for this clinician and code, from $43.95 to $83.73; 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) | $63.91median of 30 rows · $43.95–$83.73 | $96.33 | 66% | above 6% of 189 Houston neurology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $94.50median of 30 rows · $67.66–$121.10 | $137.41 | 69% | above 7% 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) | $72.25median of 12 rows · $64.00–$85.00 | $82.68 | 87% | not typically billed by neurology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $117.30median of 12 rows · $103.50–$138.00 | $138.62 | 85% | 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 Seon Kyung NAM, MD performs these services, and they are kept out of the benchmark above.