Scott WU, M.D.
Gastroenterology Physician · Houston, TX 77026 · NPI 1760426308 · 1 payer file
52%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Scott WU, M.D. $49.95 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 96 contract rows for this clinician and code, from $34.82 to $143.59; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gastroenterology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $49.95median of 96 rows · $34.82–$143.59 | $96.33 | 52% | above 0% of 214 Houston gastroenterology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $71.86median of 96 rows · $51.38–$205.26 | $137.41 | 52% | above 0% of 214 Houston gastroenterology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gastroenterology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $60.03median of 64 rows · $46.34–$125.39 | $82.68 | 73% | not typically billed by gastroenterology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $97.88median of 56 rows · $78.01–$210.24 | $138.62 | 71% | not typically billed by gastroenterology 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 Scott WU, M.D. performs these services, and they are kept out of the benchmark above.