Ashutosh Mahapatra, MD
Neurocritical Care Physician · Houston, TX 77030 · NPI 1750700522 · 1 payer file
179%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Ashutosh Mahapatra, MD $172.77 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 72 contract rows for this clinician and code, from $73.56 to $240.39; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurocritical care physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $172.77median of 72 rows · $73.56–$240.39 | $96.33 | 179% | above 94% of 17 Houston neurocritical care physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $254.73median of 72 rows · $108.33–$352.74 | $137.41 | 185% | above 94% of 17 Houston neurocritical care physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurocritical care physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $201.76median of 56 rows · $83.86–$237.38 | $82.68 | 244% | not typically billed by neurocritical care physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $347.34median of 64 rows · $267.54–$397.59 | $138.62 | 251% | not typically billed by neurocritical care 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 Ashutosh Mahapatra, MD performs these services, and they are kept out of the benchmark above.