Sarah Wilson, MD
Neurology with Special Qualifications in Child Neurology Physician · Houston, TX 77030 · NPI 1356879282
134%of Medicare
BCBSTX pays Sarah Wilson, MD $129.07 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 neurology with special qualifications in child neurology physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $129.07 | $96.33 | 134% | above 91% of 45 Houston neurology with special qualifications in child neurology physicians |
| 99214Office visit, established patient, moderate complexity | $133.97 | $137.41 | 97% | above 68% of 45 Houston neurology with special qualifications in child neurology physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $157.20 | $317.92 | 49% | not typically billed by neurology with special qualifications in child neurology physicians |
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by neurology with special qualifications in child neurology physicians |
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by neurology with special qualifications in child neurology physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by neurology with special qualifications in child neurology 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 Sarah Wilson, MD performs these services, and they are kept out of the benchmark above.