Dianne Wollaston, M.D.
Rheumatology Physician · Houston, TX 77024 · NPI 1427161637 · 1 payer file
71%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Dianne Wollaston, M.D. $68.42 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 30 contract rows for this clinician and code, from $53.95 to $80.50; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston rheumatology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $68.42median of 30 rows · $53.95–$80.50 | $96.33 | 71% | above 2% of 66 Houston rheumatology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $99.31median of 30 rows · $79.48–$116.82 | $137.41 | 72% | above 2% of 66 Houston rheumatology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston rheumatology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.67median of 18 rows · $57.93–$77.26 | $82.68 | 79% | not typically billed by rheumatology 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 Dianne Wollaston, M.D. performs these services, and they are kept out of the benchmark above.