Community/behavioral Health In Omaha Nebraska

NPI list of 111 community/behavioral health registered providers with a business address in Omaha, NE of which 99 are registered as organizations and 12 as individuals. A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

NPI Name Type Taxonomy Address Medicare PECOS
1003010398SANTA MONICAOrganizationCommunity/Behavioral Health130 N 39TH ST
OMAHA, NE 68131
(402) 558-7088
Non-Participating ProviderNO
1003979840EASTERN NEBRASKA COMMUNITY ACTION PARTNERSHIPOrganizationCommunity/Behavioral Health2406 FOWLER AVE
OMAHA, NE 68111
(402) 453-5656
Non-Participating ProviderNO
1013368018STEPHANIE LEVY LICSW LLC
STEPHANIE LEVY LICSW LLC
OrganizationCommunity/Behavioral Health11225 DAVENPORT ST SUITE 103
OMAHA, NE 68154
(402) 934-2661
Non-Participating ProviderNO
1023747615TRANSFORMATIONAL THERAPY LLCOrganizationCommunity/Behavioral Health6818 GROVER ST STE 301
OMAHA, NE 68106
(402) 650-9601
Non-Participating ProviderNO
1033302872JENNIFER M. KELLY, LCSW LLCOrganizationCommunity/Behavioral Health11330 Q ST SUITE 222
OMAHA, NE 68137
(402) 660-6846
Non-Participating ProviderNO
1043648306HOLISTIC COUNSELING LLCOrganizationCommunity/Behavioral Health11414 WEST CENTER RD STE 348
OMAHA, NE 68144
(402) 507-8710
Non-Participating ProviderNO
1053691956RENOVATISOrganizationCommunity/Behavioral Health16920 PATTERSON DR
OMAHA, NE 68135
(402) 320-5808
Non-Participating ProviderNO
1053970996SARAANN STALEY LLCOrganizationCommunity/Behavioral Health268 N 115TH ST STE 1
OMAHA, NE 68154
(402) 403-9469
Non-Participating ProviderNO
1063003499STIDHAM COUNSELING SERVICES, LLCOrganizationCommunity/Behavioral Health10824 OLD MILL RD STE 10-2
OMAHA, NE 68154
(515) 451-7523
Non-Participating ProviderNO
1063189488CHANDRA SCHWARTZIndividualCommunity/Behavioral Health5115 F ST
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1073936449NEBRASKA COUNSELING & HYPNOSIS CENTEROrganizationCommunity/Behavioral Health8031 W CENTER RD 211
OMAHA, NE 68124
(402) 393-0544
Non-Participating ProviderNO
1083157069KARA ABBOTTIndividualCommunity/Behavioral Health9215 S 169TH ST
OMAHA, NE 68136
(402) 708-9389
Non-Participating ProviderNO
1093204620MORGAN LEIFIndividualCommunity/Behavioral Health5115 F ST
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1093919508OMNI BEHAVIORAL HEALTHOrganizationCommunity/Behavioral Health5115 F ST.
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1104219500KRYSTAL FROSTIndividualCommunity/Behavioral Health1941 S 42ND ST STE 129
OMAHA, NE 68105
(402) 871-9979
Non-Participating ProviderNO
1134450935MCCULLOUGH COUNSELING & RECOVERY LLCOrganizationCommunity/Behavioral Health5951 AMES AVE # 28
OMAHA, NE 68104
(402) 457-5761
Non-Participating ProviderNO
1134463714ALPHA LIFE IMPROVEMENT SERVICESOrganizationCommunity/Behavioral Health1941 S 42ND ST STE 538
OMAHA, NE 68105
(402) 515-4874
Non-Participating ProviderNO
1134534381PARADIGM INCOrganizationCommunity/Behavioral Health809 S 174TH ST
OMAHA, NE 68118
(402) 991-8093
Non-Participating ProviderNO
1144752189RYAN MOSELEYOrganizationCommunity/Behavioral Health11907 ARBOR ST STE E
OMAHA, NE 68144
(402) 680-0548
Non-Participating ProviderNO
1154972305COMMON THREADS THERAPY, LLCOrganizationCommunity/Behavioral Health6818 GROVER ST STE 301A
OMAHA, NE 68106
(402) 577-0357
Non-Participating ProviderNO
1164808994GUARDIAN COUNSELING SERVICES, LLCOrganizationCommunity/Behavioral Health6606 S 168TH ST STE 200
OMAHA, NE 68135
(402) 618-2660
Non-Participating ProviderNO
1174156541WININGER COUNSELING LLCOrganizationCommunity/Behavioral Health11414 W CENTER RD STE 315
OMAHA, NE 68144
(402) 546-9585
Non-Participating ProviderNO
1174784821COUNSELING CONNECTIONS, LLCOrganizationCommunity/Behavioral Health11414 W CENTER RD SUITE 124
OMAHA, NE 68144
(402) 932-2296
Non-Participating ProviderNO
1184175408MCCULLOUGH COUNSELING & RECOVERY LLCOrganizationCommunity/Behavioral Health6415 AMES AVE STE C
OMAHA, NE 68104
(402) 932-2537
Non-Participating ProviderNO
1184781460APEX FOSTER CARE INCOrganizationCommunity/Behavioral Health5851 N 90TH ST
OMAHA, NE 68134
(402) 571-5400
Non-Participating ProviderNO
1194935593COUNSELING FOR GROWTH & HEALING
ELLIE FIELDS
OrganizationCommunity/Behavioral Health638 N 109TH PLZ
OMAHA, NE 68154
(402) 403-0190
Non-Participating ProviderNO
1205379245LINNETTE KRAMERIndividualCommunity/Behavioral Health1018 N 105TH ST
OMAHA, NE 68114
(402) 590-3607
Non-Participating ProviderNO
1215362496BENEFICIAL BEHAVIORAL HEALTH SERVICESOrganizationCommunity/Behavioral Health4732 S 131ST ST
OMAHA, NE 68137
(402) 697-3923
Non-Participating ProviderNO
1235212218ALLIABLE SERVICES LLCOrganizationCommunity/Behavioral Health4780 S 131ST ST SUITE D
OMAHA, NE 68137
(402) 896-8141
Non-Participating ProviderNO
1235457730REAP, INC.OrganizationCommunity/Behavioral Health1941 S 42ND ST SUITE 126
OMAHA, NE 68105
(402) 813-1125
Non-Participating ProviderNO
1255601928FAMILY FOUNDATIONS, INC.OrganizationCommunity/Behavioral Health1941 S 42ND ST STE 528
OMAHA, NE 68105
(402) 614-8444
Non-Participating ProviderNO
1255722518ANITA AKERS, PCOrganizationCommunity/Behavioral Health11713 M CIR
OMAHA, NE 68137
(402) 933-4411
Non-Participating ProviderNO
1285901439GG ENTERPRISE INC.OrganizationCommunity/Behavioral Health10040 REGENCY CIR STE 250
OMAHA, NE 68114
(402) 393-5432
Non-Participating ProviderNO
1295058733PONCA TRIBE OF NEBRASKA
FRED LEROY HEALTH AND WELLNESS CENTER
OrganizationCommunity/Behavioral Health2602 J ST
OMAHA, NE 68107
(402) 734-5275
Non-Participating ProviderNO
1316020555BENEFICIAL BEHAVIORAL HEALTH SERVICES, INC.OrganizationCommunity/Behavioral Health13435 A ST
OMAHA, NE 68144
(402) 697-3923
Non-Participating ProviderNO
1326700857STEP AHEAD ABA LLCOrganizationCommunity/Behavioral Health1299 FARNAM ST STE 300
OMAHA, NE 68102
(402) 969-6633
Non-Participating ProviderNO
1336670140KALEIGH PABENIndividualCommunity/Behavioral Health11635 ARBOR ST SUITE 110
OMAHA, NE 68144
(402) 881-5654
Non-Participating ProviderNO
1356518575HEALING AIMS & DIVERSITY SYSTEM INC
HEALING AIMS
OrganizationCommunity/Behavioral Health1941 S 42ND ST SUITE 424
OMAHA, NE 68105
(402) 905-2222
Non-Participating ProviderNO
1356894489RITONYA KOLA FAMILY SERVICES COUNSELING AND CONSULTING LLPOrganizationCommunity/Behavioral Health1299 FARNAM ST STE 300
OMAHA, NE 68102
(402) 905-1120
Non-Participating ProviderNO
1376692376NOVA TREATMENT COMMUNITY, INC.OrganizationCommunity/Behavioral Health8502 MORMON BRIDGE RD
OMAHA, NE 68152
(402) 455-8303
Non-Participating ProviderNO
1386871663HOPEFUL HEARTS COUNSELING P.C.OrganizationCommunity/Behavioral Health6324 MAPLE ST SUITE 1
OMAHA, NE 68104
(402) 916-9886
Non-Participating ProviderNO
1386904571BENEFICIAL BEHAVIORAL HEALTHOrganizationCommunity/Behavioral Health4732 S 131ST ST
OMAHA, NE 68137
(402) 697-3923
Non-Participating ProviderNO
1396263141ANGELA THOMASIndividualCommunity/Behavioral Health5115 F ST
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1407401185KATHLEEN BLAKEIndividualCommunity/Behavioral Health13322 I ST
OMAHA, NE 68137
(402) 230-5861
Non-Participating ProviderNO
1417363177RITE OF PASSAGE, INC
PAPILLION CREEK ACADEMY
OrganizationCommunity/Behavioral Health10625 CALHOUN RD
OMAHA, NE 68112
(402) 905-9600
Non-Participating ProviderNO
1437303997SENIORCARE BEHAVIORAL HEALTH ASSOCIATES, LLC PCOrganizationCommunity/Behavioral Health10815 ELM ST
OMAHA, NE 68144
(402) 690-1292
Non-Participating ProviderNO
1447397088FRIENDSHIP PROGRAM INCOrganizationCommunity/Behavioral Health7315 MAPLE ST
OMAHA, NE 68134
(402) 393-6911
Non-Participating ProviderNO
1447506241A1 HEALTH SERVICESOrganizationCommunity/Behavioral Health1941 S 42ND ST
OMAHA, NE 68105
(402) 991-8101
Non-Participating ProviderNO
1497940092A BETTER WAY THERAPYOrganizationCommunity/Behavioral Health3223 N 169TH ST
OMAHA, NE 68116
(402) 813-2235
Non-Participating ProviderNO
1518503093BEHAVIORAL HEALTH OF OMAHAOrganizationCommunity/Behavioral Health7253 GROVER ST
OMAHA, NE 68124
(402) 650-5089
Non-Participating ProviderNO
1528308376RENEWED REFLECTIONS, LLC.OrganizationCommunity/Behavioral Health6223 MAPLE ST UNIT 4871
OMAHA, NE 68104
(402) 590-4633
Non-Participating ProviderNO
1538207972OMAHA OPPORTUNITIES INDUSTRIALIZATION CENTER
ZENITH COUNSELING SERVICES
OrganizationCommunity/Behavioral Health2724 N 24TH ST
OMAHA, NE 68110
(402) 457-4222
Non-Participating ProviderNO
1538656038JOSE ANTONIO MENDOZA PINTOIndividualCommunity/Behavioral Health2505 N 24TH ST
OMAHA, NE 68110
(402) 451-5549
Non-Participating ProviderNO
1548394729JOURNEYS RECOVERY SOLUTIONS
JOURNEYS RECOVERY SOLUTIONS
OrganizationCommunity/Behavioral Health815 DORCAS ST
OMAHA, NE 68108
(402) 898-4135
Non-Participating ProviderNO
1548721814DEVINE COUNSELING AND CONSULTING, LLCOrganizationCommunity/Behavioral Health4611 S 96TH ST STE 225
OMAHA, NE 68127
(402) 578-1255
Non-Participating ProviderNO
1558506212CARTER RELATIONSHIP DEVELOPMENT & COUNSELING CENTER
CARTER COUNSELING CENTER
OrganizationCommunity/Behavioral Health8031 W. CENTER RD. STE 206
OMAHA, NE 68124
(402) 502-1716
Non-Participating ProviderNO
1558793216BEHAVEN KIDS-OMAHA, LLCOrganizationCommunity/Behavioral Health8922 CUMING ST
OMAHA, NE 68114
(402) 923-4373
Non-Participating ProviderNO
1568059962WHOLE COLLECTIVE, LLCOrganizationCommunity/Behavioral Health415 LEAVENWORTH ST APT 367
OMAHA, NE 68102
(402) 658-5809
Non-Participating ProviderNO
1578086294NEBRASKA FAMILY SUPPORT NETWORKOrganizationCommunity/Behavioral Health3568 DODGE ST STE 2
OMAHA, NE 68131
(402) 345-0791
Non-Participating ProviderNO
1578614988COMMUNITY ALLIANCE REHABILITATION SERVICESOrganizationCommunity/Behavioral Health4001 LEAVENWORTH ST
OMAHA, NE 68105
(402) 341-5128
Non-Participating ProviderNO
1578736864NEBRASKA URBAN INDIAN HEALTH COALITIONOrganizationCommunity/Behavioral Health2240 LANDON COURT
OMAHA, NE 68102
(402) 346-0902
Non-Participating ProviderNO
1578962072ACHIEVE BALANCE COUNSELINGOrganizationCommunity/Behavioral Health10806 PRAIRIE HILLS DR
OMAHA, NE 68144
(402) 210-7673
Non-Participating ProviderNO
1598171340ASPIRATIONS COUNSELING, LLCOrganizationCommunity/Behavioral Health11433 ARBOR ST APT 104
OMAHA, NE 68144
(402) 880-5253
Non-Participating ProviderNO
1619016896THE SALVATION ARMYOrganizationCommunity/Behavioral Health3612 CUMING ST
OMAHA, NE 68131
(402) 898-5900
Non-Participating ProviderNO
1619332459NEBRASKA URBAN INDIAN HEALTH COALITIONOrganizationCommunity/Behavioral Health2240 LANDON CT
OMAHA, NE 68102
(402) 346-0902
Non-Participating ProviderNO
1619409091PATRICIA BROOKSOrganizationCommunity/Behavioral Health8420 W DODGE RD
OMAHA, NE 68114
(402) 215-3893
Non-Participating ProviderNO
1639592348CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA, INCOrganizationCommunity/Behavioral Health3300 N 60TH ST
OMAHA, NE 68104
(402) 554-0520
Non-Participating ProviderNO
1659928331JLR COUNSELING, LLCOrganizationCommunity/Behavioral Health2566 FARNAM ST STE 301A
OMAHA, NE 68131
(712) 355-1526
Non-Participating ProviderNO
1669694949NOVA TREATMENT COMMUNITY, INC.OrganizationCommunity/Behavioral Health8502 MORMON BRIDGE RD
OMAHA, NE 68152
(402) 455-8303
Non-Participating ProviderNO
1679018030BUOYANT FAMILY SERVICES COUNSELING AND CONSULTING LLCOrganizationCommunity/Behavioral HealthTHE CENTER 1941 SOUTH 42ND STREET SUITE 416 S
OMAHA, NE 68105
(402) 905-1120
Non-Participating ProviderNO
1679742126SIGMA TREATMENT FOSTER CARE, INC.OrganizationCommunity/Behavioral Health5620 AMES AVE
OMAHA, NE 68104
(402) 453-5388
Non-Participating ProviderNO
1679929970LIONROCK BEHAVIORAL HEALTH, INC
LIONROCK RECOVERY
OrganizationCommunity/Behavioral Health2111 S 67TH ST STE 300
OMAHA, NE 68106
(760) 994-4990
Non-Participating ProviderNO
1679985634RED LOTUS COUNSELING, LLCOrganizationCommunity/Behavioral Health3675 N 129TH ST
OMAHA, NE 68164
(402) 740-4879
Non-Participating ProviderNO
1689004624OMNI BEHAVIORAL HEALTHOrganizationCommunity/Behavioral Health5115 F ST
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1699421479JANNA THOMAS THERAPY, LLCOrganizationCommunity/Behavioral Health11640 ARBOR ST STE 101
OMAHA, NE 68144
(402) 414-4787
Non-Participating ProviderNO
1700171741PANDO GERIATRIC COUNSELING, PCOrganizationCommunity/Behavioral Health10806 PRAIRIE HILLS DR
OMAHA, NE 68144
(402) 321-8995
Non-Participating ProviderNO
1700195435CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA INC
JOURNEYS
OrganizationCommunity/Behavioral Health11111 M ST
OMAHA, NE 68137
(402) 504-4099
Non-Participating ProviderNO
1700238441JEAN STUTO THERAPY LLCOrganizationCommunity/Behavioral Health3112 N 58TH ST
OMAHA, NE 68104
(402) 972-6049
Non-Participating ProviderNO
1700420320BRANDY S BROWNIndividualCommunity/Behavioral Health5115 F ST
OMAHA, NE 68117
(402) 397-9866
Non-Participating ProviderNO
1720540859PROSIGHTFUL COUNSELING AND CONSULTING, INC
PROSIGHTFUL
OrganizationCommunity/Behavioral Health6311 AMES AVE # 1048
OMAHA, NE 68104
(402) 953-4240
Non-Participating ProviderNO
1720613714WILLOW COUNSELING, LLCOrganizationCommunity/Behavioral Health444 REGENCY PARKWAY DR STE 104
OMAHA, NE 68114
(402) 932-2296
Non-Participating ProviderNO
1720667553BOESIGER COUNSELING, LLCOrganizationCommunity/Behavioral Health11615 I ST
OMAHA, NE 68137
(402) 513-0148
Non-Participating ProviderNO
1740605724REBECCA ANN TUNZERIndividualCommunity/Behavioral Health3300 N 60TH ST
OMAHA, NE 68104
(402) 554-0520
Non-Participating ProviderNO
1750619516PEACE AND POWER COUNSELING LLCOrganizationCommunity/Behavioral Health6901 DODGE ST STE 101
OMAHA, NE 68132
(402) 515-7412
Non-Participating ProviderNO
1760680409TIFFANY D. KOENEN, LCSW, P.C.OrganizationCommunity/Behavioral Health8021 CHICAGO ST
OMAHA, NE 68114
(402) 502-1024
Non-Participating ProviderNO
1770801250BAKERS PSYCHIATRY CONSULTING P COrganizationCommunity/Behavioral Health7205 W CENTER RD SUITE # 100
OMAHA, NE 68124
(402) 504-3707
Non-Participating ProviderNO
1770801789MARY JO HANIGAN M.D., P.C.OrganizationCommunity/Behavioral Health7205 W CENTER RD SUITE # 100
OMAHA, NE 68124
(402) 504-3707
Non-Participating ProviderNO
1770885840LIFE ENHANCEMENT SERVICES, LLCOrganizationCommunity/Behavioral Health2221 N 24TH ST
OMAHA, NE 68110
(704) 342-9595
Non-Participating ProviderNO
1780882571KEVIN J. MCKENZIE, LLCOrganizationCommunity/Behavioral Health8021 CHICAGO ST
OMAHA, NE 68114
(402) 502-1024
Non-Participating ProviderNO
1780894691FAMILY STRATEGIES,PCOrganizationCommunity/Behavioral Health11414 W CENTER RD STE 215
OMAHA, NE 68144
(402) 334-0628
Non-Participating ProviderNO
1790153617ANSWERS FOR AUTISM, LLCOrganizationCommunity/Behavioral Health6424 S 150TH ST.
OMAHA, NE 68137
(402) 812-5939
Non-Participating ProviderNO
1801107677COMMUNITY LIFE SKILLS CONNECTIONOrganizationCommunity/Behavioral Health3830 BURT ST
OMAHA, NE 68131
(402) 690-0475
Non-Participating ProviderNO
1811135189CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA INC
JOURNEYS
OrganizationCommunity/Behavioral Health11111 M ST
OMAHA, NE 68137
(402) 898-4135
Non-Participating ProviderNO
1811292287WOMENS CENTER FOR ADVANCEMENTOrganizationCommunity/Behavioral Health222 S 29TH ST
OMAHA, NE 68131
(402) 345-6555
Non-Participating ProviderNO
1831726215PERCEPTIONS LLCOrganizationCommunity/Behavioral Health1299 FARNAM ST STE 300
OMAHA, NE 68102
(402) 414-4131
Non-Participating ProviderNO
1831843903THRIVING FUTURES LLCOrganizationCommunity/Behavioral Health10826 OLD MILL RD STE 8
OMAHA, NE 68154
(402) 370-9147
Non-Participating ProviderNO
1851568323NU BEGINNINGS TREATMENT FOSTER CAREOrganizationCommunity/Behavioral Health5951 AMES AVE
OMAHA, NE 68104
(402) 916-9133
Non-Participating ProviderNO
1861875791PROJECT HARMONYOrganizationCommunity/Behavioral Health11949 Q ST
OMAHA, NE 68137
(402) 595-1059
Non-Participating ProviderNO
1861902405ADRIANA NIEMANN COUNSELING ,L.L.C.OrganizationCommunity/Behavioral Health4610 N 126TH AVE
OMAHA, NE 68164
(402) 686-5881
Non-Participating ProviderNO
1871244087VIDA SANA COUNSELING LLCOrganizationCommunity/Behavioral Health13110 EDNA ST
OMAHA, NE 68138
(402) 305-7214
Non-Participating ProviderNO
1912223843MEREDITH JOY GECK LLCOrganizationCommunity/Behavioral Health7205 W CENTER RD SUITE # 100
OMAHA, NE 68124
(402) 504-3707
Non-Participating ProviderNO
1912235458KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
KVC NEBRASKA
OrganizationCommunity/Behavioral Health11550 I ST STE 100
OMAHA, NE 68137
(402) 498-4700
Non-Participating ProviderNO
1922455708GREATER DYNAMICS, INC.OrganizationCommunity/Behavioral Health13006 BOYD CIR
OMAHA, NE 68164
(402) 740-9389
Non-Participating ProviderNO
1922457431CONFIDENTIAL COUNSELING AND CONSULTINGOrganizationCommunity/Behavioral Health1941 S 42ND ST 110
OMAHA, NE 68105
(402) 457-5761
Non-Participating ProviderNO
1932712619COMPREHENSIVE BEHAVIOR SUPPORTS OF NEBRASKA LLCOrganizationCommunity/Behavioral Health1299 FARNAM ST STE 300
OMAHA, NE 68102
(718) 633-4411
Non-Participating ProviderNO
1942406061IN HARMONY COUNSELING & CONSULTATIONOrganizationCommunity/Behavioral Health2529 S 133RD PLZ
OMAHA, NE 68144
(403) 933-3600
Non-Participating ProviderNO
1962999201CONNIE ROGERSIndividualCommunity/Behavioral Health2505 N 24TH ST
OMAHA, NE 68110
(402) 451-5549
Non-Participating ProviderNO
1982023735ABINTRA COUNSELING CENTER, P.C.OrganizationCommunity/Behavioral Health4730 S 131ST ST
OMAHA, NE 68137
(402) 933-1504
Non-Participating ProviderNO
1982942397EPIPHANAL MOMENTS COUNSELING AGENCYOrganizationCommunity/Behavioral Health11414 W CENTER RD STE 325
OMAHA, NE 68144
(402) 709-5928
Non-Participating ProviderNO
1992944086CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA, INC.
CATHOLIC CHARITIES
OrganizationCommunity/Behavioral Health5211 S 31ST ST
OMAHA, NE 68107
(402) 731-5413
Non-Participating ProviderNO
1992976062KATE FISCHER COUNSELING SERVICES, P.C.OrganizationCommunity/Behavioral Health11330 Q ST STE 225
OMAHA, NE 68137
(402) 597-2312
Non-Participating ProviderNO

Medicare Participation

  • Participating providers are registered with Medicare and accept claims assignment. Taking claims assignment means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or co-payment amount for a visit or service.
  • Non-Participating providers do not agree to take Medicare claims assignment. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
  • Opt-out providers signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so.

What is PECOS?

PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals eligible to order or refer healthcare services for Medicare patients.