DR. GRADY F MURPHY JR. M.D.
NPI 1306815923
Internal Medicine in Bedford, TX

Medicare Participation & PECOS Enrollment Status

Grady Murphy 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.

Grady Murphy 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: 4981697877

  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: I20040406001347

  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.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 142 times for 22 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 127 times for 22 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 87 times for 58 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 130 times for 126 patients

Evaluation of swallowing function image

An evaluation of swallowing function image is a diagnostic procedure. It involves capturing images of your throat as you swallow. This helps identify any issues with swallowing, which could be due to various conditions like stroke, cancer, or nerve disease.

This service was performed 156 times for 152 patients

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose

Hyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.

This service was performed 67 times for 15 patients

Imaging for evaluation of swallowing function

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

This service was performed 35 times for 35 patients

Imaging for evaluation of swallowing function

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

This service was performed 520 times for 502 patients

Injection of contrast for imaging of knee joint

This procedure involves injecting a contrast agent into the knee joint to enhance imaging clarity. The contrast helps highlight structures like ligaments, cartilage, and tendons, aiding in accurate diagnosis. It's generally safe with minor discomfort.

This service was performed 18 times for 15 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 67 times for 54 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 17 times for 14 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 147 times for 147 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 346 times for 346 patients

Review by radiologist of knee joint image

A radiologist, a doctor specialized in interpreting medical images, examines your knee joint image. This helps identify issues like fractures, arthritis, or other abnormalities. This review is vital for accurate diagnosis and treatment planning.

This service was performed 104 times for 44 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 40 times for 40 patients

Single contrast x-ray of upper digestive tract

A single contrast x-ray of the upper digestive tract is a diagnostic procedure that uses a special dye and x-rays to see how your digestive system is functioning. It helps in detecting abnormalities or diseases in your esophagus, stomach, and the first part of your small intestine.

This service was performed 34 times for 34 patients

Single contrast x-ray of upper digestive tract

A single contrast x-ray of the upper digestive tract is a diagnostic procedure that uses a special dye and x-rays to see how your digestive system is functioning. It helps in detecting abnormalities or diseases in your esophagus, stomach, and the first part of your small intestine.

This service was performed 516 times for 498 patients

Ultrasound of aorta, vena cava, groin vessels or bypass grafts

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps doctors check for issues like blockages or enlargements. It's non-invasive and painless.

This service was performed 47 times for 47 patients

Ultrasound of heart, follow-up

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

This service was performed 47 times for 47 patients

Ultrasound of one side of head and neck blood flow

An ultrasound of one side of the head and neck blood flow is a non-invasive procedure that uses sound waves to create images of blood vessels. It helps identify any blockages or abnormalities in blood flow, aiding in early detection of potential health issues.

This service was performed 47 times for 47 patients

Ultrasound study of arm and leg arteries

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

This service was performed 48 times for 47 patients

X-ray of chest, 1 view

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

This service was performed 19 times for 19 patients

X-ray of chest, 1 view

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

This service was performed 223 times for 213 patients

X-ray of part of lower jaw, 1-4 views

An X-ray of the lower jaw, with 1-4 views, is a non-invasive imaging procedure. It helps visualize the jaw structure, checking for issues like fractures, infections, or dental problems. It's quick, painless, and provides valuable information for your treatment plan.

This service was performed 34 times for 34 patients

X-ray of part of lower jaw, 1-4 views

An X-ray of the lower jaw, with 1-4 views, is a non-invasive imaging procedure. It helps visualize the jaw structure, checking for issues like fractures, infections, or dental problems. It's quick, painless, and provides valuable information for your treatment plan.

This service was performed 520 times for 502 patients

X-ray of soft tissue of neck

An X-ray of the soft tissue of the neck is a non-invasive imaging test that helps visualize the tissues and structures in your neck area. It can detect issues like infections, tumors, or injuries. It involves exposure to a small amount of radiation and usually takes a few minutes.

This service was performed 34 times for 34 patients

X-ray of soft tissue of neck

An X-ray of the soft tissue of the neck is a non-invasive imaging test that helps visualize the tissues and structures in your neck area. It can detect issues like infections, tumors, or injuries. It involves exposure to a small amount of radiation and usually takes a few minutes.

This service was performed 520 times for 502 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 34 times for 34 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 518 times for 500 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.4 for a new patient copayment and $24.92 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 76021 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 25.86, 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: 25.86 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: 26.66

  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: 0

  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: 17.31

  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: 17.31

  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.

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