Leah Schenk, M.D.
Reproductive Endocrinology Physician · Houston, TX 77054 · NPI 1699777953 · 2 payer files
102%of Medicare
Cigna — Houston FlexCare pays Leah Schenk, M.D. $97.97 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 2 contract rows for this clinician and code, from $82.67 to $113.27; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston reproductive endocrinology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Houston FlexCare | $97.97median of 2 rows · $82.67–$113.27 | $96.33 | 102% | above 77% of 858 all Houston clinicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $106.62median of 28 rows · $60.93–$142.16 | $96.33 | 111% | above 89% of 29 Houston reproductive endocrinology physicians on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Houston FlexCare | $141.12median of 2 rows · $122.05–$160.19 | $137.41 | 103% | above 76% of 858 all Houston clinicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $154.56median of 28 rows · $93.57–$206.08 | $137.41 | 112% | above 89% of 29 Houston reproductive endocrinology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston reproductive endocrinology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Houston FlexCare | $82.08median of 2 rows · $77.47–$86.69 | $82.68 | 99% | not typically billed by reproductive endocrinology physicians |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.25median of 12 rows · $101.70–$135.60 | $82.68 | 139% | not typically billed by reproductive endocrinology physicians | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Houston FlexCare | $137.98median of 2 rows · $130.43–$145.52 | $138.62 | 100% | not typically billed by reproductive endocrinology physicians |
| Aetna — Texas (office visit and psychotherapy codes only) | $203.90median of 12 rows · $179.91–$239.89 | $138.62 | 147% | not typically billed by reproductive endocrinology physicians | |
| 70553MRI brain, with and without contrast | Cigna — Houston FlexCare | $304.38 | $317.92 | 96% | not typically billed by reproductive endocrinology physicians |
| 72148MRI lumbar spine, without contrast | Cigna — Houston FlexCare | $182.18 | $192.38 | 95% | not typically billed by reproductive endocrinology physicians |
| 74177CT abdomen and pelvis, with contrast | Cigna — Houston FlexCare | $290.72 | $300.72 | 97% | not typically billed by reproductive endocrinology physicians |
| 77067Screening mammography, bilateral | Cigna — Houston FlexCare | $117.58 | $126.38 | 93% | not typically billed by reproductive endocrinology 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 Leah Schenk, M.D. performs these services, and they are kept out of the benchmark above.