RAM Saha, M.D
General Acute Care Hospital · Houston, TX 77030 · NPI 1730556259 · 1 payer file
118%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays RAM Saha, M.D $113.44 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 64 contract rows for this clinician and code, from $78.90 to $160.06; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston general acute care hospitals, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $113.44median of 64 rows · $78.90–$160.06 | $96.33 | 118% | above 83% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $170.16median of 64 rows · $121.70–$235.94 | $137.41 | 124% | above 84% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston general acute care hospitals, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $125.35median of 64 rows · $96.34–$145.33 | $82.68 | 152% | not typically billed by general acute care hospitals |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $210.56median of 64 rows · $162.03–$243.39 | $138.62 | 152% | not typically billed by general acute care hospitals |
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 RAM Saha, M.D performs these services, and they are kept out of the benchmark above.