BRIAN ROBERT PETERS MD
NPI 1124076062
Otolaryngology in Dallas, TX

Medicare Participation & PECOS Enrollment Status

Brian Peters is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Brian Peters 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 4486721206

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20111216000329

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Analysis and programming of inner ear implant (7 years or older)

Analysis and programming of an inner ear implant involves checking the implant's functionality and adjusting its settings for optimal hearing. It's a non-invasive procedure that helps tailor the device to your unique hearing needs, improving your ability to perceive sound.

This service was performed 24 times for 24 patients

Analysis and reprogramming of inner ear implant (7 years or older)

An analysis and reprogramming of an inner ear implant involves checking the device's performance and adjusting its settings for optimal hearing. This non-invasive procedure helps ensure the implant continues to meet the patient's hearing needs.

This service was performed 282 times for 133 patients

Comprehensive hearing and speech recognition test

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

This service was performed 471 times for 434 patients

Creation of skin, fat and muscle graft

A skin, fat, and muscle graft involves taking a piece of healthy tissue from one area of your body and moving it to another area that needs help healing. This helps replace damaged or missing tissue and promote healing.

This service was performed 30 times for 28 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 204 times for 138 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 34 times for 28 patients

Evaluation and testing for balance with recording

This procedure involves a series of evaluations and tests to analyze your balance. Recordings are made to track your performance, helping identify any issues. This aids in determining the best treatment for any balance disorders you may have.

This service was performed 19 times for 19 patients

Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes

This procedure assesses how well your surgically implanted hearing device is working. It involves testing your hearing abilities for every additional 15 minutes. It helps in making necessary adjustments to improve your hearing experience.

This service was performed 106 times for 33 patients

Evaluation of hearing function related to surgically implanted hearing device, first hour

This procedure assesses how well your surgically implanted hearing device is working. It involves a series of tests conducted over an hour to measure your hearing ability and device performance. It's a crucial step in ensuring your hearing health.

This service was performed 334 times for 145 patients

Insertion of cochlear device

A cochlear device is a small electronic device that can help improve hearing. Its insertion involves a surgical procedure where the device is placed under the skin behind the ear. It works by directly stimulating the hearing nerve, aiding those with severe hearing loss.

This service was performed 23 times for 23 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 33 times for 33 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 52 times for 52 patients

Repair of opening to cochlea

The repair of the cochlea opening is a surgical procedure aimed at fixing an abnormal opening in the cochlea, part of your inner ear. This can help improve hearing and balance issues, reducing symptoms like dizziness or hearing loss.

This service was performed 22 times for 22 patients

Test for ability to detect and repeat spoken words with speech recognition

This is a hearing test where you'll listen to spoken words through headphones and repeat them. It helps evaluate your ability to understand speech. It's a simple, non-invasive procedure that provides valuable information about your hearing health.

This service was performed 53 times for 42 patients

Test for abnormal eye movement with recording

This procedure checks for unusual eye movement. It involves recording your eye movements while you follow a light or object with your eyes. This helps identify any issues with how your eyes move or focus, aiding in the diagnosis of certain conditions.

This service was performed 19 times for 18 patients

Test for hearing various pitches using earphone

This is a hearing test where earphones are worn to detect different pitch levels. Sounds of various frequencies are played, and you indicate when you hear them. This helps evaluate your hearing ability. It's safe, comfortable, and non-invasive.

This service was performed 53 times for 42 patients

Test for hearing various pitches using earphone and device placed against the bone

This is a hearing test that checks your ability to hear different pitches or frequencies. It involves wearing earphones and placing a device against your bone, usually behind the ear. It helps identify any hearing issues you might have.

This service was performed 13 times for 13 patients

Test to assess balance during warm and cool irrigation in both ears

This is a test called caloric stimulation, used to check your balance function. During this procedure, warm and cool water are gently introduced into your ears. Your eye movements are then observed, as they can indicate issues with balance or inner ear function.

This service was performed 16 times for 16 patients

Test to assess balance during warm or cool irrigation in both ears

This procedure, known as caloric testing, helps evaluate balance. Warm or cool water or air is gently introduced into your ears. This stimulates inner ear sensors, causing eye movements that can indicate balance issues. It's non-invasive and safe.

This service was performed 17 times for 17 patients

Test to assess middle ear function

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

This service was performed 211 times for 195 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.75 for a new patient copayment and $17.82 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 75230 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.

• Final Score: 75 out of 100

  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.
  
  

• Quality Score: N/A

  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 Score: N/A

  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.

• Improvement Activities Score: N/A

  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 activities measure category compromises 15% providers final MPIS scores.
  
  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.

• Cost Score: N/A

  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.

• Cost Score: N/A

  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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Brian Peters is affiliated with the following medical facilities:

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