Justin Elhoff, M.D.
Pediatric Critical Care Medicine Physician · Houston, TX 77030 · NPI 1720216211 · 1 payer file
322%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Justin Elhoff, M.D. $310.52 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 12 contract rows for this clinician and code, from $254.76 to $366.29; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric critical care medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $310.52median of 12 rows · $254.76–$366.29 | $96.33 | 322% | above 100% of 123 Houston pediatric critical care medicine physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $465.05median of 12 rows · $390.98–$539.11 | $137.41 | 338% | above 100% of 123 Houston pediatric critical care medicine physicians on this plan |