Daniel Karb
Gastroenterology Physician · Houston, TX 77030 · NPI 1619339470 · 1 payer file
182%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Daniel Karb $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 96 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 gastroenterology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $174.93median of 96 rows · $129.61–$240.39 | $96.33 | 182% | above 90% of 214 Houston gastroenterology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $257.51median of 96 rows · $191.04–$352.74 | $137.41 | 187% | above 90% of 214 Houston gastroenterology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gastroenterology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $207.30median of 64 rows · $159.63–$237.38 | $82.68 | 251% | not typically billed by gastroenterology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $347.34median of 96 rows · $267.54–$397.59 | $138.62 | 251% | not typically billed by gastroenterology 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 Daniel Karb performs these services, and they are kept out of the benchmark above.