Kira LIN, MD
Ophthalmology Physician · Houston, TX 77030 · NPI 1629714241 · 1 payer file
225%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Kira LIN, MD $216.37 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 8 contract rows for this clinician and code, from $176.98 to $255.75; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston ophthalmology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $216.37median of 8 rows · $176.98–$255.75 | $96.33 | 225% | above 100% of 170 Houston ophthalmology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $323.38median of 8 rows · $270.43–$376.32 | $137.41 | 235% | above 100% of 169 Houston ophthalmology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston ophthalmology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $225.73median of 8 rows · $221.22–$230.24 | $82.68 | 273% | not typically billed by ophthalmology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $375.71median of 8 rows · $367.96–$383.46 | $138.62 | 271% | not typically billed by ophthalmology 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 Kira LIN, MD performs these services, and they are kept out of the benchmark above.