Disha Jain, DO
Child Abuse Pediatrics Physician · Houston, TX 77030 · NPI 1548880313 · 1 payer file
111%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Disha Jain, DO $106.62 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 28 contract rows for this clinician and code, from $60.93 to $142.16; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston child abuse pediatrics physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $106.62median of 28 rows · $60.93–$142.16 | $96.33 | 111% | above 69% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $154.56median of 28 rows · $93.57–$206.08 | $137.41 | 112% | above 70% 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 child abuse pediatrics physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.25median of 12 rows · $101.70–$135.60 | $82.68 | 139% | not typically billed by child abuse pediatrics physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $203.90median of 12 rows · $179.91–$239.89 | $138.62 | 147% | not typically billed by child abuse pediatrics 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 Disha Jain, DO performs these services, and they are kept out of the benchmark above.