AMY Pearson, M.D.
Interventional Pain Medicine Physician · Houston, TX 77024 · NPI 1447249289 · 1 payer file
67%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays AMY Pearson, M.D. $64.93 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 92 contract rows for this clinician and code, from $53.95 to $81.60; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston interventional pain medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $64.93median of 92 rows · $53.95–$81.60 | $96.33 | 67% | above 9% of 23 Houston interventional pain medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $92.37median of 72 rows · $79.48–$118.37 | $137.41 | 67% | above 10% of 22 Houston interventional pain medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston interventional pain medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 36 rows · $57.93–$81.11 | $82.68 | 81% | not typically billed by interventional pain medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 36 rows · $102.01–$136.81 | $138.62 | 83% | not typically billed by interventional pain 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 AMY Pearson, M.D. performs these services, and they are kept out of the benchmark above.