Mohamed Gabr, MD
Clinical Cardiac Electrophysiology Physician · Houston, TX 77030 · NPI 1023536620 · 1 payer file
70%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Mohamed Gabr, MD $67.79 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 56 contract rows for this clinician and code, from $39.89 to $139.67; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical cardiac electrophysiology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $67.79median of 56 rows · $39.89–$139.67 | $96.33 | 70% | above 3% of 40 Houston clinical cardiac electrophysiology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.85median of 66 rows · $54.00–$199.24 | $137.41 | 71% | above 5% of 40 Houston clinical cardiac electrophysiology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston clinical cardiac electrophysiology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $86.66median of 32 rows · $70.26–$119.88 | $82.68 | 105% | not typically billed by clinical cardiac electrophysiology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $134.66median of 24 rows · $118.81–$158.42 | $138.62 | 97% | not typically billed by clinical cardiac electrophysiology 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 Mohamed Gabr, MD performs these services, and they are kept out of the benchmark above.