Alice YAO, MD
Plastic Surgery Physician · Houston, TX 77030 · NPI 1366600736 · 1 payer file
75%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Alice YAO, MD $72.31 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 48 contract rows for this clinician and code, from $39.89 to $192.00; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $72.31median of 48 rows · $39.89–$192.00 | $96.33 | 75% | above 27% of 42 Houston plastic surgery physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.85median of 58 rows · $54.00–$263.00 | $137.41 | 71% | above 2% of 43 Houston plastic surgery physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $86.66median of 16 rows · $70.26–$178.00 | $82.68 | 105% | not typically billed by plastic surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $146.54median of 16 rows · $118.82–$351.00 | $138.62 | 106% | not typically billed by plastic 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 Alice YAO, MD performs these services, and they are kept out of the benchmark above.