Robert Leath, M.D., R.PH.
Addiction Medicine (Family Medicine) Physician · Houston, TX 77080 · NPI 1780693911
86%of Medicare
BCBSTX pays Robert Leath, M.D., R.PH. $82.74 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 addiction medicine (family medicine) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $82.74 | $96.33 | 86% | above 73% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $87.82 | $137.41 | 64% | above 51% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $278.39 | $317.92 | 88% | not typically billed by addiction medicine (family medicine) physicians |
| 72148MRI lumbar spine, without contrast | $59.92 | $192.38 | 31% | not typically billed by addiction medicine (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 Robert Leath, M.D., R.PH. performs these services, and they are kept out of the benchmark above.