Laura Martinez Muniz, P.T.
Pediatric Physical Therapist · Houston, TX 77063 · NPI 1225302268
44%of Medicare
BCBSTX pays Laura Martinez Muniz, P.T. $42.66 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston pediatric physical therapists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $42.66 | $96.33 | 44% | above 0% of 14 Houston pediatric physical therapists |
| 99214Office visit, established patient, moderate complexity | $65.75 | $137.41 | 48% | above 0% of 14 Houston pediatric physical therapists |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $252.85 | $317.92 | 80% | not typically billed by pediatric physical therapists |
| 72148MRI lumbar spine, without contrast | $151.55 | $192.38 | 79% | not typically billed by pediatric physical therapists |
| 74177CT abdomen and pelvis, with contrast | $239.31 | $300.72 | 80% | not typically billed by pediatric physical therapists |
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 Laura Martinez Muniz, P.T. performs these services, and they are kept out of the benchmark above.