|Provider Name||DR. MATTHEW C BESSETTE M.D.|
|Provider Location Address||20 HAGEN DR STE 110 ROCHESTER, NY 14625|
|Provider Mailing Address||20 HAGEN DRIVE SUITE 110 ROCHESTER, NY 14625|
|NPI Entity Type||Individual|
|Medical School Name||UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE|
|Is Sole Proprietor?||No|
|Last Update Date||07-21-2022|
Matthew Bessette is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Matthew Bessette is registered with Medicare and accepts claims assignment, this 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 copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Rochester General Hospital.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 99.8, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The following quality measures were reported for this provider: annual registration in the prescription drug monitoring program, closing the referral loop: receipt of specialist report, consultation of the prescription drug monitoring program, engagement of new medicaid patients and follow-up, e-prescribing, implementation of use of specialist reports back to referring clinician or group to close referral loop, invasive procedure or surgery anticoagulation medication management, osteoarthritis (oa): function and pain assessment, patient-centered surgical risk assessment and communication, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms., request/accept summary of care, security risk analysis, send a summary of care and use of certified ehr to capture patient reported outcomes.
|Type||Allopathic & Osteopathic Physicians|
|Taxonomy Description||An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.|
DR. MATTHEW C BESSETTE M.D.
20 HAGEN DR STE 110
Phone: (585) 218-9651
Fax: (585) 267-4037
DR. MATTHEW C BESSETTE M.D.
20 HAGEN DRIVE
Phone: (585) 218-9651
Fax: (585) 267-4037
601 Elmwood Ave Box 665
Rochester, NY 14642
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||6800187535|
|PECOS Enrollment ID||I20171013001438|
|Accepts Medicare Assignment?|| Yes "What does it mean "accepts medicare assignment"?|
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
|Eligible order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Overall MIPS Quality Performance
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
|MIPS Measure||Score Weight||Score|
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
|Promoting Interoperability (PI)||25%||84.3|
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
|MIPS Final Score||-||99.8|
|The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.|
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
|Quality Measure||Performance||Number of Patients|
|Annual registration in the Prescription Drug Monitoring Program||Yes||N/A|
|Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.|
|Closing the Referral Loop: Receipt of Specialist Report||100%||176|
|Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred|
|Consultation of the Prescription Drug Monitoring Program||Yes||N/A|
|Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.|
|Engagement of New Medicaid Patients and Follow-up||Yes||N/A|
|Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.|
|At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.|
|Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop||Yes||N/A|
|Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.|
|Invasive Procedure or Surgery Anticoagulation Medication Management||Yes||N/A|
|For an anticoagulated patient undergoing a planned invasive procedure for which interruption in anticoagulation is anticipated, including patients taking vitamin K antagonists (warfarin), target specific oral anticoagulants (such as apixaban, dabigatran, and rivaroxaban), and heparins/low molecular weight heparins, documentation, including through the use of electronic tools, that the plan for anticoagulation management in the periprocedural period was discussed with the patient and with the clinician responsible for managing the patient’s anticoagulation. Elements of the plan should include the following: discontinuation, resumption, and, if applicable, bridging, laboratory monitoring, and management of concomitant antithrombotic medications (such as antiplatelets and nonsteroidal anti-inflammatory drugs (NSAIDs)). An invasive or surgical procedure is defined as a procedure in which skin or mucous membranes and connective tissue are incised, or an instrument is introduced through a natural body orifice.|
|Osteoarthritis (OA): Function and Pain Assessment||100%||767|
|Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain|
|Patient-Centered Surgical Risk Assessment and Communication||100%||148|
|Percentage of patients who underwent a non-emergency surgery who had their personalized risks of postoperative complications assessed by their surgical team prior to surgery using a clinical data-based, patient-specific risk calculator and who received personal discussion of those risks with the surgeon|
|Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record||Yes||N/A|
|• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.|
|Provide Patient Access||100%||31|
|For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology.|
|Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.||Yes||N/A|
|Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.|
|Request/Accept Summary of Care||9%||501|
|For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an electronic summary of care document.|
|Security Risk Analysis||Yes||N/A|
|Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.|
|Send a Summary of Care||1%||752|
|For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record.|
|Use of certified EHR to capture patient reported outcomes||Yes||N/A|
|In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.|
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Matthew Bessette is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|ROCHESTER GENERAL HOSPITAL||1425 PORTLAND AVENUE|
ROCHESTER, NY 14621
|(585) 922-4000||Acute Care Hospitals||330125|
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||207X00000X||Allopathic & Osteopathic Physicians||Orthopaedic Surgery||288040||NY||No|
Taxonomy Description: an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
|2||390200000X||Student, Health Care||Student in an Organized Health Care Education/Training Program||No|
Taxonomy Description: an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State||Identifier Issuer|
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
|Start with the original NPI number, the last digit is the check digit and is not used in the calculation.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 0 + 1 + 6 + 3 + 1 + 8 + 0 + 6 + 3 + 1 + 4 + 24 = 59|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|60 - 59 = 1||1|
The NPI number 1083903371 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Dr. Matthew C Bessette M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.