Jamie KU, M.D.
Otolaryngology/Facial Plastic Surgery Physician · Houston, TX 77030 · NPI 1508187576 · 1 payer file
182%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Jamie KU, M.D. $174.93 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 64 contract rows for this clinician and code, from $129.61 to $240.39; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston otolaryngology/facial plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $174.93median of 64 rows · $129.61–$240.39 | $96.33 | 182% | above 91% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $257.51median of 64 rows · $191.04–$352.74 | $137.41 | 187% | above 93% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston otolaryngology/facial plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $207.30median of 48 rows · $159.63–$237.38 | $82.68 | 251% | not typically billed by otolaryngology/facial plastic surgery physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $347.34median of 64 rows · $267.54–$397.59 | $138.62 | 251% | not typically billed by otolaryngology/facial 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 Jamie KU, M.D. performs these services, and they are kept out of the benchmark above.