Susan DAY
Psychologist · Houston, TX 77019 · NPI 1548995251
67%of Medicare
BCBSTX pays Susan DAY $64.09 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 psychologists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $64.09 | $96.33 | 67% | above 90% of 127 Houston psychologists |
| 99214Office visit, established patient, moderate complexity | $93.89 | $137.41 | 68% | above 11% of 127 Houston psychologists |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $27.87 | $126.38 | 22% | not typically billed by psychologists |
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 Susan DAY performs these services, and they are kept out of the benchmark above.