Kristi Kway
Student in an Organized Health Care Education/Training Program · Houston, TX 77030 · NPI 1225788854
115%of Medicare
BCBSTX pays Kristi Kway $111.04 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 student in an organized health care education/training programs |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $111.04 | $96.33 | 115% | above 84% of 63 Houston student in an organized health care education/training programs |
| 99214Office visit, established patient, moderate complexity | $121.98 | $137.41 | 89% | above 68% of 63 Houston student in an organized health care education/training programs |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $214.58 | $317.92 | 67% | not typically billed by student in an organized health care education/training programs |
| 72148MRI lumbar spine, without contrast | $853.39 | $192.38 | 444% | not typically billed by student in an organized health care education/training programs |
| 74177CT abdomen and pelvis, with contrast | $161.40 | $300.72 | 54% | not typically billed by student in an organized health care education/training programs |
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 Kristi Kway performs these services, and they are kept out of the benchmark above.