John Beetz, MD
Hospitalist Physician · Houston, TX 77030 · NPI 1740921634 · 1 payer file
121%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays John Beetz, MD $116.22 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 32 contract rows for this clinician and code, from $82.25 to $194.27; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospitalist physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $116.22median of 32 rows · $82.25–$194.27 | $96.33 | 121% | above 94% of 304 Houston hospitalist physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $169.59median of 32 rows · $121.19–$277.77 | $137.41 | 123% | above 94% of 304 Houston hospitalist physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospitalist physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $125.54median of 48 rows · $96.50–$165.82 | $82.68 | 152% | not typically billed by hospitalist physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $211.53median of 32 rows · $162.88–$278.16 | $138.62 | 153% | not typically billed by hospitalist 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 John Beetz, MD performs these services, and they are kept out of the benchmark above.