Cole Lewis, M.D.
Neurological Surgery Physician · Houston, TX 77030 · NPI 1356738181 · 1 payer file
76%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Cole Lewis, M.D. $73.01 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 82 contract rows for this clinician and code, from $51.14 to $108.84; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurological surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $73.01median of 82 rows · $51.14–$108.84 | $96.33 | 76% | above 10% of 124 Houston neurological surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $105.96median of 80 rows · $78.45–$153.18 | $137.41 | 77% | above 10% of 124 Houston neurological surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurological surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $67.42median of 48 rows · $49.50–$85.59 | $82.68 | 82% | not typically billed by neurological surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $130.47median of 8 rows · $130.07–$130.87 | $138.62 | 94% | not typically billed by neurological 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 Cole Lewis, M.D. performs these services, and they are kept out of the benchmark above.