Jose Portugal Gonzales, MD
Infectious Disease Physician · Houston, TX 77030 · NPI 1396304945
69%of Medicare
BCBSTX pays Jose Portugal Gonzales, MD $66.02 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 infectious disease physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $66.02 | $96.33 | 69% | above 59% of 129 Houston infectious disease physicians |
| 99214Office visit, established patient, moderate complexity | $140.45 | $137.41 | 102% | above 76% of 129 Houston infectious disease physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $136.24 | $317.92 | 43% | not typically billed by infectious disease physicians |
| 72148MRI lumbar spine, without contrast | $87.88 | $192.38 | 46% | not typically billed by infectious disease physicians |
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by infectious disease physicians |
| 77067Screening mammography, bilateral | $161.89 | $126.38 | 128% | not typically billed by infectious disease 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 Jose Portugal Gonzales, MD performs these services, and they are kept out of the benchmark above.