DR. IAN M PURCELL MD
NPI 1124233739
Psychiatry & Neurology - Neurology in San Diego, CA

Medicare Participation & PECOS Enrollment Status

Ian Purcell 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.

Ian Purcell 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: 8022096965

  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: I20040712000514

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) (HCPCS:A4222)

  1 DME suppliers used 14 Medicare Claims 50 Services Paid

• DME-Other DME (DE001N)

  Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

  6 DME suppliers used 55 Medicare Claims 55 Services Paid

• DME-Other DME (DE001N)

  Full face mask used with positive airway pressure device, each (HCPCS:A7030)

  4 DME suppliers used 33 Medicare Claims 33 Services Paid

• DME-Other DME (DE001N)

  Face mask interface, replacement for full face mask, each (HCPCS:A7031)

  4 DME suppliers used 33 Medicare Claims 96 Services Paid

• DME-Other DME (DE001N)

  Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

  3 DME suppliers used 17 Medicare Claims 100 Services Paid

• DME-Other DME (DE001N)

  Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

  4 DME suppliers used 15 Medicare Claims 89 Services Paid

• DME-Other DME (DE001N)

  Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

  5 DME suppliers used 34 Medicare Claims 34 Services Paid

• DME-Other DME (DE001N)

  Headgear used with positive airway pressure device (HCPCS:A7035)

  5 DME suppliers used 40 Medicare Claims 40 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  6 DME suppliers used 58 Medicare Claims 344 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  3 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Other DME (DE001N)

  Continuous positive airway pressure (cpap) device (HCPCS:E0601)

  4 DME suppliers used 124 Medicare Claims 124 Services Paid

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD021N)

  Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

Unknown

• Treatment-Injections and Infusions (nononcologic) (RI008N)

  Injection, immune globulin (hizentra), 100 mg (HCPCS:J1559)

  1 DME suppliers used 13 Medicare Claims 9200 Services Paid

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.

Electrocardiogram (ecg) 2-day continuous

An Electrocardiogram (ECG) 2-day continuous is a non-invasive test that records the electrical activity of your heart over 48 hours. It helps to detect irregular heart rhythms, heart disease, or other cardiac conditions. You wear a portable device that records heart activity as you go about your daily activities.

This service was performed 42 times for 42 patients

Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming

This procedure involves using electronic systems to evaluate and adjust an implanted neurostimulator generator. This device aids in controlling nerve activity in the brain, helping manage conditions like epilepsy or chronic pain. It's a non-invasive process that ensures optimal device performance.

This service was performed 26 times for 11 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 366 times for 291 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 4,271 times for 1,519 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 106 times for 103 patients

Exam of neurobehavioral status, first hour

An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.

This service was performed 183 times for 182 patients

Injection of anesthetic agent and/or steroid into upper neck and back of head nerve

This procedure involves injecting a mix of anesthetic and/or steroid into nerves in the upper neck and back of the head. It helps relieve pain by reducing inflammation and numbing the area. It's a common treatment for headaches and neck pain.

This service was performed 123 times for 59 patients

Injection of carpal tunnel

An injection for carpal tunnel is a treatment to reduce inflammation and swelling in your wrist, which can alleviate pain and numbness. The doctor injects a steroid medication into your wrist area to provide relief.

This service was performed 32 times for 20 patients

Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face

This procedure involves injecting a chemical into specific facial and neck muscles, causing temporary paralysis. This helps reduce muscle activity and can alleviate certain medical conditions. Both sides of the face are treated for a balanced result.

This service was performed 159 times for 68 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 169 times for 77 patients

Injection of trigger points, 3 or more muscles

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

This service was performed 281 times for 110 patients

Injection, onabotulinumtoxina, 1 unit

Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.

This service was performed 27,592 times for 66 patients

Measurement of brain wave activity (eeg), awake and drowsy

Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.

This service was performed 42 times for 42 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 210 times for 202 patients

Nerve conduction, 13 or more studies

Nerve conduction studies involve 13 or more tests to check the speed and strength of signals traveling between your nerves and muscles. It helps diagnose conditions affecting nerves and muscles. The test involves small shocks and may cause minor discomfort.

This service was performed 24 times for 24 patients

Nerve conduction, 5-6 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.

This service was performed 71 times for 71 patients

Nerve conduction, 9-10 studies

Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.

This service was performed 113 times for 110 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 19 times for 19 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 772 times for 772 patients

Photography of content of eyes

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

This service was performed 1,303 times for 750 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 57 times for 50 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

This service was performed 106 times for 53 patients

Removal of impacted ear wax

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

This service was performed 348 times for 280 patients

Repositioning exercises of head for treatment of dizziness, each day

Repositioning exercises of the head help manage dizziness by training your brain to cope with the signals that trigger this sensation. Daily, gentle movements of the head and body can reduce symptoms and improve balance.

This service was performed 678 times for 329 patients

Telephone medical discussion with physician, 11-20 minutes

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

This service was performed 14 times for 14 patients

Telephone medical discussion with physician, 21-30 minutes

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

This service was performed 118 times for 98 patients

Test for abnormal eye movement using 3 positions with recording

This test checks for unusual eye movements. You'll be asked to look in three different directions while a device records your eye movements. It helps identify any eye muscle or nerve issues. It's non-invasive and painless.

This service was performed 1,151 times for 742 patients

Test for abnormal eye movement using a rotating chair

A rotating chair test helps doctors assess balance issues. You'll sit in a motorized chair that spins at controlled speeds. As the chair moves, your eye movements are monitored to identify any irregularities, which can indicate balance disorders.

This service was performed 1,121 times for 729 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 1,158 times for 744 patients

Test for balance and posture

A balance and posture test assesses your ability to maintain steady positioning and coordination. It involves simple tasks like standing on one foot or walking in a straight line. This helps identify any issues with your balance system, which can affect daily activities.

This service was performed 609 times for 607 patients

Test for eardrum and muscle function

This test assesses the health of your eardrum and muscles linked to hearing. A small device is placed in your ear that creates pressure changes and sounds. Your ear's responses are recorded to determine if they are functioning properly.

This service was performed 411 times for 410 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 120 times for 117 patients

Use of electrodes during balance testing

Balance testing with electrodes involves attaching small sensors to your skin. These sensors record your body's responses to various balance tests. They help in assessing your balance and coordination by measuring your body's electrical activity as you perform specific tasks.

This service was performed 122 times for 119 patients

Vemp testing of lower branch of inner ear nerve with interpretation and report

VEMP testing is a safe procedure used to evaluate the functioning of your inner ear nerves. It involves playing sounds into your ears and recording the responses from your muscles. This helps detect any abnormalities in your inner ear. The results are then interpreted and reported by a specialist.

This service was performed 107 times for 107 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.05 for a new patient copayment and $27.1 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 92111 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 78.16, 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 provider also has detailed performance information the following quality measures: .

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: 78.16 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: 56.32

  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: 40

  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.

MIPS Quality Measures

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