Megan Belcher, D.O.
Family Medicine Physician · Houston, TX 77008 · NPI 1306167473 · 1 payer file
75%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Megan Belcher, D.O. $72.04 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. The file lists 56 contract rows for this clinician and code, from $61.45 to $170.65; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $72.04median of 56 rows · $61.45–$170.65 | $96.33 | 75% | above 40% of 623 Houston family medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $111.44median of 60 rows · $89.93–$243.66 | $137.41 | 81% | above 45% of 632 Houston family medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $76.87median of 30 rows · $57.64–$149.06 | $82.68 | 93% | not typically billed by family medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $143.81median of 20 rows · $107.87–$249.87 | $138.62 | 104% | not typically billed by family medicine 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 Megan Belcher, D.O. performs these services, and they are kept out of the benchmark above.