Muhammad Hossain, MD
Emergency Medical Services (Emergency Medicine) Physician · Houston, TX 77002 · NPI 1700852845
53%of Medicare
BCBSTX pays Muhammad Hossain, MD $50.62 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 | BCBSTX | Medicare | % of Medicare | Among Houston emergency medical services (emergency medicine) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $50.62 | $96.33 | 53% | above 7% of 16 Houston emergency medical services (emergency medicine) physicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 0% of 16 Houston emergency medical services (emergency medicine) physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $277.41 | $317.92 | 87% | not typically billed by emergency medical services (emergency medicine) physicians |
| 72148MRI lumbar spine, without contrast | $176.75 | $192.38 | 92% | not typically billed by emergency medical services (emergency medicine) physicians |
| 74177CT abdomen and pelvis, with contrast | $78.35 | $300.72 | 26% | not typically billed by emergency medical services (emergency medicine) physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by emergency medical services (emergency medicine) 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 Muhammad Hossain, MD performs these services, and they are kept out of the benchmark above.