Ilya Dubovoy, M.D.
Neurology Physician · Houston, TX 77030 · NPI 1508390261 · 1 payer file
89%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Ilya Dubovoy, M.D. $85.89 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 96 contract rows for this clinician and code, from $52.30 to $141.21; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $85.89median of 96 rows · $52.30–$141.21 | $96.33 | 89% | above 54% of 189 Houston neurology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $125.82median of 112 rows · $80.68–$198.68 | $137.41 | 92% | above 55% of 189 Houston neurology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston neurology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $89.31median of 24 rows · $74.34–$111.00 | $82.68 | 108% | not typically billed by neurology 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 Ilya Dubovoy, M.D. performs these services, and they are kept out of the benchmark above.