ASHOK MODHA M.D.
NPI 1275575789
Neurological Surgery in Vancouver, WA

Medicare Participation & PECOS Enrollment Status

Ashok Modha 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.

Ashok Modha 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: 941283170

  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: I20040609001120, I20140827001874

  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.

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 91 times for 74 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 88 times for 77 patients

Injection, gadobutrol, 0.1 ml

Gadobutrol is a contrast agent used during MRI scans to help provide clearer images. It's injected into your vein before the scan. This helps doctors to see certain areas more clearly for better diagnosis. It's generally safe with few side effects.

This service was performed 2,026 times for 18 patients

Laminectomy or laminotomy (partial removal of spine bones)

A laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.

This service was performed for 100 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

Mri scan of brain before and after contrast

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

This service was performed 28 times for 11 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 14 times for 14 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 104 times for 104 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 28 times for 28 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 31 times for 31 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

This service was performed 36 times for 20 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 1-10 patients

Use of operating microscope

An operating microscope is a device that magnifies small areas, allowing surgeons to see fine details clearly during procedures. It's often used for delicate operations like eye or nerve surgery, improving precision and outcomes.

This service was performed 11 times for 11 patients

X-ray of upper spine, 4-5 views

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

This service was performed 15 times for 15 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.74 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 98664 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.

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. Ashok Modha is affiliated with the following medical facilities:

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Frequently Asked Questions