Madiha Ghayas, M.D.
Psychiatry Physician · Houston, TX 77084 · NPI 1609199926 · 3 payer files
85%of Medicare
Cigna — Texas Connect (individual & family) pays Madiha Ghayas, M.D. $82.00 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.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston psychiatry physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $82.00 | $96.33 | 85% | above 65% of 249 Houston psychiatry physicians on this plan |
| UnitedHealthcare — Optum Behavioral Health | $81.58 | $96.33 | 85% | above 9% of 204 Houston psychiatry physicians on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 20 rows · $55.30–$81.60 | $96.33 | 72% | above 25% of 404 Houston psychiatry physicians on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $119.00 | $137.41 | 87% | above 65% of 249 Houston psychiatry physicians on this plan |
| UnitedHealthcare — Optum Behavioral Health | $120.38 | $137.41 | 88% | above 10% of 197 Houston psychiatry physicians on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 20 rows · $81.21–$118.37 | $137.41 | 73% | above 29% of 404 Houston psychiatry physicians on this plan | |
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $78.00 | $82.68 | 94% | above 80% of 249 Houston psychiatry physicians on this plan |
| UnitedHealthcare — Optum Behavioral Health | $76.03 | $82.68 | 92% | above 12% of 197 Houston psychiatry physicians on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.73–$78.30 | $82.68 | 81% | above 17% of 380 Houston psychiatry physicians on this plan | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $130.00 | $138.62 | 94% | above 87% of 249 Houston psychiatry physicians on this plan |
| UnitedHealthcare — Optum Behavioral Health | $126.72 | $138.62 | 91% | above 90% of 197 Houston psychiatry physicians on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 12 rows · $102.01–$136.02 | $138.62 | 83% | above 16% of 213 Houston psychiatry physicians on this plan |