Babak Baharloo
Podiatrist · Houston, TX 77035 · NPI 1740662147 · 1 payer file
116%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Babak Baharloo $111.62 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 12 contract rows for this clinician and code, from $80.98 to $118.30; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston podiatrists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $111.62median of 12 rows · $80.98–$118.30 | $96.33 | 116% | above 98% of 43 Houston podiatrists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $139.03median of 12 rows · $119.77–$158.28 | $137.41 | 101% | above 74% of 43 Houston podiatrists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston podiatrists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $93.00median of 8 rows · $79.71–$106.28 | $82.68 | 112% | not typically billed by podiatrists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $173.96median of 8 rows · $149.11–$198.81 | $138.62 | 125% | not typically billed by podiatrists |
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 Babak Baharloo performs these services, and they are kept out of the benchmark above.