Evan Schauer, M.D.
Internal Medicine Physician · Houston, TX 77025 · NPI 1679194013 · 1 payer file
56%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Evan Schauer, M.D. $53.55 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 $39.04 to $73.38; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston internal medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $53.55median of 36 rows · $39.04–$73.38 | $96.33 | 56% | above 0% of 898 Houston internal medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $80.50median of 36 rows · $60.10–$107.83 | $137.41 | 59% | above 0% of 899 Houston internal medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston internal medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $51.30median of 24 rows · $42.39–$64.12 | $82.68 | 62% | not typically billed by internal medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $86.25median of 24 rows · $71.43–$107.68 | $138.62 | 62% | not typically billed by internal 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 Evan Schauer, M.D. performs these services, and they are kept out of the benchmark above.