Chester KOH, MD
Pediatric Urology Physician · Houston, TX 77030 · NPI 1225133846 · 1 payer file
83%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Chester KOH, MD $79.58 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 20 contract rows for this clinician and code, from $54.32 to $103.75; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric urology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $79.58median of 20 rows · $54.32–$103.75 | $96.33 | 83% | above 33% of 10 Houston pediatric urology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $117.61median of 20 rows · $83.63–$149.96 | $137.41 | 86% | above 33% of 10 Houston pediatric urology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric urology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $90.31median of 12 rows · $80.00–$106.25 | $82.68 | 109% | not typically billed by pediatric urology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $146.62median of 12 rows · $129.37–$172.50 | $138.62 | 106% | not typically billed by pediatric urology 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 Chester KOH, MD performs these services, and they are kept out of the benchmark above.