Francisco Carrillo Morales, DDS, MSD
Oral and Maxillofacial Surgery (Dentist) · Houston, TX 77030 · NPI 1730691049 · 1 payer file
111%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Francisco Carrillo Morales, DDS, MSD $106.62 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 28 contract rows for this clinician and code, from $60.93 to $142.16; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston oral and maxillofacial surgery (dentist)s, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $106.62median of 28 rows · $60.93–$142.16 | $96.33 | 111% | above 50% of 15 Houston oral and maxillofacial surgery (dentist)s on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $154.56median of 28 rows · $93.57–$206.08 | $137.41 | 112% | above 50% of 15 Houston oral and maxillofacial surgery (dentist)s on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston oral and maxillofacial surgery (dentist)s, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $115.25median of 12 rows · $101.70–$135.60 | $82.68 | 139% | not typically billed by oral and maxillofacial surgery (dentist)s |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $203.90median of 12 rows · $179.91–$239.89 | $138.62 | 147% | not typically billed by oral and maxillofacial surgery (dentist)s |
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 Francisco Carrillo Morales, DDS, MSD performs these services, and they are kept out of the benchmark above.