ROBERT C HINZE DPM
NPI 1134206121
Podiatrist in Mccook, NE

Medicare Participation & PECOS Enrollment Status

Robert Hinze 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.

Robert Hinze 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) and a Home Health Agency (HHA).

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: 42284911

  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: I20040825000909, I20180509002553

  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: No

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.

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe (HCPCS:A5500)

  2 DME suppliers used 99 Medicare Claims 196 Services Paid

• DME-Orthotic Devices (DF000N)

  For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each (HCPCS:A5512)

  2 DME suppliers used 53 Medicare Claims 312 Services Paid

• DME-Orthotic Devices (DF000N)

  For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each (HCPCS:A5513)

  3 DME suppliers used 48 Medicare Claims 272 Services Paid

• DME-Orthotic Devices (DF003N)

  Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf (HCPCS:L1906)

  2 DME suppliers used 14 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF000N)

  Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L4386)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Orthotic Devices (DF000N)

  Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L4396)

  2 DME suppliers used 14 Medicare Claims 16 Services Paid

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA023N)

  Collagen based wound filler, dry form, sterile, per gram of collagen (HCPCS:A6010)

  2 DME suppliers used 23 Medicare Claims 215 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)

  2 DME suppliers used 55 Medicare Claims 411 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6216)

  2 DME suppliers used 24 Medicare Claims 595 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6219)

  2 DME suppliers used 24 Medicare Claims 245 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Hydrogel dressing, wound filler, gel, per fluid ounce (HCPCS:A6248)

  2 DME suppliers used 43 Medicare Claims 45 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.

Destruction of precancer skin growth, 1 growth

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

This service was performed 38 times for 19 patients

Destruction of precancer skin growth, 2-14 growths

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

This service was performed 22 times for 12 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 54 times for 20 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 302 times for 157 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 650 times for 293 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 15 times for 12 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 15 times for 14 patients

Injection, ceftriaxone sodium, per 250 mg

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

This service was performed 52 times for 15 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 45 times for 22 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 102 times for 22 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 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 105 times for 105 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 150 times for 150 patients

Permanent removal fingernail or toenail

Permanent removal of a fingernail or toenail, also known as avulsion, is a procedure performed to treat nail infections or severe ingrown nails. The nail is carefully removed under local anesthesia. After removal, a chemical is applied to prevent nail regrowth, ensuring the issue does not recur.

This service was performed 21 times for 19 patients

Removal of fingernails or toenails, 1-5 nails

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

This service was performed 77 times for 30 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 85 times for 44 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 391 times for 171 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 49 times for 27 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 40 times for 18 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 147 times for 66 patients

Removal of noncancer thickened skin growth, more than 4 growths

This procedure involves the removal of more than four noncancerous, thickened skin growths. It's a simple process where a healthcare professional uses a specialized tool to carefully remove these growths, promoting healthier skin.

This service was performed 70 times for 30 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 42 times for 23 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 102 times for 47 patients

Therapy procedure using ultrasound

Ultrasound therapy is a treatment used to heal and relieve pain. It involves using sound waves to stimulate body tissues, promoting healing and reducing inflammation. It's non-invasive, painless, and typically used for muscle, ligament injuries, or chronic pain.

This service was performed 73 times for 17 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 71 times for 30 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.3 for a new patient copayment and $16.5 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 69001 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 94.57, 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: 94.57 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: 87.26

  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 comprises 40% of a provider's final MIPS score.
  
  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: 94.37

  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 comprises 25% of a provider's final MIPS score.
  
  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 comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: N/A

  The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.

MIPS Quality Measures

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. Robert Hinze is affiliated with the following medical facilities:

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