PHU VO, DPM
Podiatrist · Houston, TX 77021 · NPI 1205067394 · 1 payer file
71%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays PHU VO, DPM $68.05 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 $53.88 to $80.06; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston podiatrists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $68.05median of 30 rows · $53.88–$80.06 | $96.33 | 71% | above 19% of 43 Houston podiatrists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $100.69median of 30 rows · $82.72–$118.46 | $137.41 | 73% | above 64% of 43 Houston podiatrists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston podiatrists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $60.72median of 12 rows · $53.58–$71.44 | $82.68 | 73% | not typically billed by podiatrists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $100.91median of 12 rows · $89.04–$118.72 | $138.62 | 73% | not typically billed by podiatrists |
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 PHU VO, DPM performs these services, and they are kept out of the benchmark above.