Alicia Demarco Voltz, M.D.
Pediatric Critical Care Medicine Physician · Houston, TX 77030 · NPI 1376856450 · 1 payer file
86%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Alicia Demarco Voltz, M.D. $82.56 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 16 contract rows for this clinician and code, from $60.24 to $104.89; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric critical care medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $82.56median of 16 rows · $60.24–$104.89 | $96.33 | 86% | above 5% of 123 Houston pediatric critical care medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $118.66median of 16 rows · $88.43–$148.88 | $137.41 | 86% | above 4% of 123 Houston pediatric critical care medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric critical care medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $77.80median of 16 rows · $68.51–$87.09 | $82.68 | 94% | not typically billed by pediatric critical care medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $130.36median of 12 rows · $114.75–$145.96 | $138.62 | 94% | not typically billed by pediatric critical care medicine 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 Alicia Demarco Voltz, M.D. performs these services, and they are kept out of the benchmark above.
