Robert Wians, MD, MPH
Emergency Medicine Physician · Houston, TX 77030 · NPI 1629607205 · 1 payer file
57%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Robert Wians, MD, MPH $54.59 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 36 contract rows for this clinician and code, from $40.45 to $73.67; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston emergency medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $54.59median of 36 rows · $40.45–$73.67 | $96.33 | 57% | above 0% of 402 Houston emergency medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $78.68median of 24 rows · $59.55–$103.94 | $137.41 | 57% | above 0% of 415 Houston emergency medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston emergency medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $56.08median of 24 rows · $46.74–$69.62 | $82.68 | 68% | not typically billed by emergency medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $94.59median of 36 rows · $79.04–$117.19 | $138.62 | 68% | not typically billed by emergency 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 Robert Wians, MD, MPH performs these services, and they are kept out of the benchmark above.