Hany Abd-el Malek, M.D.
Critical Care Medicine (Anesthesiology) Physician · Houston, TX 77005 · NPI 1457397978 · 1 payer file
108%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Hany Abd-el Malek, M.D. $104.11 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 118 contract rows for this clinician and code, from $55.29 to $251.88; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston critical care medicine (anesthesiology) physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $104.11median of 118 rows · $55.29–$251.88 | $96.33 | 108% | above 40% of 16 Houston critical care medicine (anesthesiology) physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $124.71median of 114 rows · $81.20–$371.93 | $137.41 | 91% | above 20% of 16 Houston critical care medicine (anesthesiology) physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston critical care medicine (anesthesiology) physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $73.29median of 42 rows · $58.72–$96.98 | $82.68 | 89% | not typically billed by critical care medicine (anesthesiology) physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $131.81median of 24 rows · $109.79–$163.78 | $138.62 | 95% | not typically billed by critical care medicine (anesthesiology) 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 Hany Abd-el Malek, M.D. performs these services, and they are kept out of the benchmark above.