Gengwen Tian, MD. PH.D
Pediatrics Physician · Houston, TX 77030 · NPI 1336592815
121%of Medicare
BCBSTX pays Gengwen Tian, MD. PH.D $116.53 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 pediatrics physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $116.53 | $96.33 | 121% | above 76% of 769 Houston pediatrics physicians |
| 99214Office visit, established patient, moderate complexity | $123.69 | $137.41 | 90% | above 39% of 766 Houston pediatrics physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by pediatrics 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 Gengwen Tian, MD. PH.D performs these services, and they are kept out of the benchmark above.