Rosemary Kozar, M.D.
Trauma Surgery Physician · Houston, TX 77030 · NPI 1336178508 · 1 payer file
88%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Rosemary Kozar, M.D. $84.66 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. The file lists 32 contract rows for this clinician and code, from $57.30 to $194.01; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston trauma surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $84.66median of 32 rows · $57.30–$194.01 | $96.33 | 88% | above 58% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $124.91median of 32 rows · $88.11–$285.84 | $137.41 | 91% | above 59% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston trauma surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $80.76median of 32 rows · $61.92–$177.13 | $82.68 | 98% | not typically billed by trauma surgery 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 Rosemary Kozar, M.D. performs these services, and they are kept out of the benchmark above.