Priya Mahajan, MD
Pediatric Hematology & Oncology Physician · Houston, TX 77030 · NPI 1861719510 · 1 payer file
148%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Priya Mahajan, MD $142.63 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 42 contract rows for this clinician and code, from $72.15 to $192.06; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric hematology & oncology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $142.63median of 42 rows · $72.15–$192.06 | $96.33 | 148% | above 98% of 132 Houston pediatric hematology & oncology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $202.59median of 56 rows · $86.95–$271.76 | $137.41 | 147% | above 94% of 132 Houston pediatric hematology & oncology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pediatric hematology & oncology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $117.01median of 18 rows · $103.24–$137.65 | $82.68 | 142% | not typically billed by pediatric hematology & oncology 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 Priya Mahajan, MD performs these services, and they are kept out of the benchmark above.