Lysbeth Rodriguez, OTR/L
Occupational Therapist · Houston, TX 77081 · NPI 1225322738
44%of Medicare
BCBSTX pays Lysbeth Rodriguez, OTR/L $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 occupational therapists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $42.66 | $96.33 | 44% | above 0% of 188 Houston occupational therapists |
| 99214Office visit, established patient, moderate complexity | $65.75 | $137.41 | 48% | above 0% of 188 Houston occupational 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 occupational therapists |
| 72148MRI lumbar spine, without contrast | $151.55 | $192.38 | 79% | not typically billed by occupational therapists |
| 74177CT abdomen and pelvis, with contrast | $239.31 | $300.72 | 80% | not typically billed by occupational therapists |
| 77067Screening mammography, bilateral | $28.12 | $126.38 | 22% | not typically billed by occupational 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 Lysbeth Rodriguez, OTR/L performs these services, and they are kept out of the benchmark above.