Bich-may Nguyen
Family Medicine Physician · Houston, TX 77074 · NPI 1720248396 · 2 payer files
94%of Medicare
UnitedHealthcare — Optum Behavioral Health pays Bich-may Nguyen $90.82 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.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family medicine physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | UnitedHealthcare — Optum Behavioral Health | $90.82 | $96.33 | 94% | above 67% of 718 all Houston clinicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $106.39median of 12 rows · $89.33–$123.46 | $96.33 | 110% | above 65% of 623 Houston family medicine physicians on this plan | |
| 99214Office visit, established patient, moderate complexity | UnitedHealthcare — Optum Behavioral Health | $128.43 | $137.41 | 93% | above 67% of 711 all Houston clinicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $152.86median of 8 rows · $131.57–$174.15 | $137.41 | 111% | above 64% of 632 Houston family medicine physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family medicine physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $76.03 | $82.68 | 92% | not typically billed by family medicine physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | UnitedHealthcare — Optum Behavioral Health | $116.57 | $138.62 | 84% | not typically billed by family 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 Bich-may Nguyen performs these services, and they are kept out of the benchmark above.