Disha Modi, DPT
Physical Therapist · Houston, TX 77060 · NPI 1861255929 · 1 payer file
69%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Disha Modi, DPT $66.65 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 48 contract rows for this clinician and code, from $37.82 to $117.64; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physical therapists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $66.65median of 48 rows · $37.82–$117.64 | $96.33 | 69% | above 39% of 104 Houston physical therapists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $98.08median of 48 rows · $58.34–$165.30 | $137.41 | 71% | above 41% of 106 Houston physical therapists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physical therapists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $55.47median of 24 rows · $46.18–$68.95 | $82.68 | 67% | not typically billed by physical therapists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $93.16median of 24 rows · $77.67–$115.64 | $138.62 | 67% | not typically billed by physical therapists |
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 Disha Modi, DPT performs these services, and they are kept out of the benchmark above.