Gina Stubbs, DO
Family Medicine Physician · Houston, TX 77028 · NPI 1770596041
119%of Medicare
BCBSTX pays Gina Stubbs, DO $114.29 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston family medicine physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $114.29 | $96.33 | 119% | above 95% of 762 Houston family medicine physicians |
| 99214Office visit, established patient, moderate complexity | $148.93 | $137.41 | 108% | above 92% of 754 Houston family medicine physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $289.94 | $317.92 | 91% | not typically billed by family medicine physicians |
| 72148MRI lumbar spine, without contrast | $62.41 | $192.38 | 32% | not typically billed by family medicine physicians |
| 74177CT abdomen and pelvis, with contrast | $77.04 | $300.72 | 26% | not typically billed by family medicine physicians |
| 77067Screening mammography, bilateral | $32.25 | $126.38 | 26% | not typically billed by family medicine 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 Gina Stubbs, DO performs these services, and they are kept out of the benchmark above.