Howard Martin, MD
Dermatopathology (Pathology) Physician · Houston, TX 77092 · NPI 1366421927
58%of Medicare
BCBSTX pays Howard Martin, MD $55.78 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 dermatopathology (pathology) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $55.78 | $96.33 | 58% | above 53% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 26% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $319.68 | $317.92 | 101% | not typically billed by dermatopathology (pathology) physicians |
| 74177CT abdomen and pelvis, with contrast | $113.29 | $300.72 | 38% | not typically billed by dermatopathology (pathology) physicians |
| 77067Screening mammography, bilateral | $44.86 | $126.38 | 35% | not typically billed by dermatopathology (pathology) 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 Howard Martin, MD performs these services, and they are kept out of the benchmark above.