DR. PETER LEIF BERGSAGEL M.D.
NPI 1316920150
Internal Medicine - Hematology & Oncology in Scottsdale, AZ

Medicare Participation & PECOS Enrollment Status

Peter Bergsagel 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.

Peter Bergsagel 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: 6800862806

  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: I20040909000817

  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.

Administration of additional new drug or substance into vein using push technique

This procedure involves injecting a new medication or substance directly into your vein using a method called the 'push' technique. It's a quick way to deliver medication into your bloodstream for fast-acting relief or treatment.

This service was performed 18 times for 14 patients

Administration of additional new drug or substance into vein, 1 hour or less

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

This service was performed 58 times for 46 patients

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 210 times for 177 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 64 times for 43 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

This service was performed 25 times for 25 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

This service was performed 49 times for 39 patients

Collection of blood sample from implanted device

Collection of a blood sample from an implanted device involves drawing blood from a device placed under your skin. This device, often a port or catheter, allows easy access to your bloodstream. The procedure is usually quick and causes minimal discomfort.

This service was performed 79 times for 64 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 26 times for 22 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 199 times for 151 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 75 times for 66 patients

Infusion into a vein for hydration, 31-60 minutes

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

This service was performed 25 times for 21 patients

Infusion into a vein for hydration, each additional hour

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

This service was performed 53 times for 30 patients

Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion

An infusion into a vein is a method of delivering medication, nutrients, or fluids directly into your bloodstream. If it's concurrent with another infusion, it means two different solutions are given at the same time. This can be for treatment, prevention, or diagnostic purposes.

This service was performed 22 times for 22 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 26 times for 24 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

This service was performed 39 times for 24 patients

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour

This procedure involves delivering medication, fluids, or nutrients directly into your vein. This is done to treat, prevent, or diagnose various conditions. Each additional hour refers to the extended time you may need to receive these substances for optimal results.

This service was performed 42 times for 26 patients

Infusion, normal saline solution , 1000 cc

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

This service was performed 38 times for 29 patients

Infusion, normal saline solution, sterile (500 ml = 1 unit)

An infusion of a normal saline solution is a common medical procedure. Sterile saline (salt water) is administered into your bloodstream via a drip. This helps to maintain fluid balance in your body, especially when you're unable to drink enough liquids.

This service was performed 25 times for 17 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 299 times for 121 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 80 times for 62 patients

Injection, azacitidine, 1 mg

Azacitidine is a medication administered via injection to treat certain types of blood or bone marrow cancer. This drug works by slowing or stopping the growth of cancer cells. It's typically given in a clinic or hospital setting by a healthcare professional.

This service was performed 2,520 times for 11 patients

Injection, carboplatin, 50 mg

Carboplatin is a chemotherapy drug used to treat various types of cancer by slowing or stopping the growth of cancer cells. The 50 mg injection is administered into a vein by a healthcare professional. Side effects may occur.

This service was performed 145 times for 17 patients

Injection, daratumumab, 10 mg and hyaluronidase-fihj

Daratumumab and hyaluronidase-fihj is an injection administered to treat certain types of blood cancer. The medication works by targeting and killing specific cancer cells. It's often given under the skin to reduce side effects and improve patient comfort.

This service was performed 5,040 times for 26 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 2,100 times for 17 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 988 times for 74 patients

Injection, diphenhydramine hcl, up to 50 mg

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

This service was performed 46 times for 39 patients

Injection, docetaxel, 1 mg

Docetaxel is a medication given via injection to treat various types of cancer. It works by stopping cancer cells from growing and dividing. Each injection contains 1 mg of docetaxel. Side effects can occur, so regular monitoring is essential.

This service was performed 1,582 times for 12 patients

Injection, fosaprepitant, 1 mg

Fosaprepitant is an anti-nausea medication given via injection. It's often used to prevent nausea and vomiting caused by chemotherapy. This injection blocks signals to the brain that trigger these symptoms, helping you feel better.

This service was performed 5,700 times for 33 patients

Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg

Gemcitabine hydrochloride is a medication given via injection to treat certain types of cancer. The 200 mg dose is administered by a healthcare professional. The drug works by slowing or stopping the growth of cancer cells in the body. It's important to follow your doctor's instructions while receiving this treatment.

This service was performed 232 times for 23 patients

Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg

The Gammagard Liquid injection is a type of immune globulin therapy. It's used to boost your body's immune system, helping it fight off infections. The therapy involves injecting a liquid form of proteins, collected from healthy donors, into your body. This is a 500mg dose.

This service was performed 940 times for 11 patients

Injection, ondansetron hydrochloride, per 1 mg

Ondansetron hydrochloride is a medication given via injection to help prevent nausea and vomiting, often due to chemotherapy or surgery. It works by blocking certain chemicals in the body that trigger these symptoms.

This service was performed 996 times for 91 patients

Injection, oxaliplatin, 0.5 mg

Oxaliplatin is a chemotherapy drug that is administered via injection. It works by stopping cancer cells from growing and dividing, which helps in the treatment of certain types of cancer. The dosage is 0.5 mg, and it's important to follow your doctor's instructions for this treatment.

This service was performed 4,600 times for 11 patients

Injection, paclitaxel, 1 mg

Paclitaxel is a medication administered via injection to treat various types of cancer. It works by inhibiting cell division, thus preventing cancer cells from growing and multiplying. Each dose is tailored to the patient's body size.

This service was performed 3,300 times for 14 patients

Injection, palonosetron hcl, 25 mcg

Palonosetron HCL is an injection used to prevent nausea and vomiting caused by chemotherapy. It works by blocking a natural substance (serotonin) in the body that can cause vomiting. This helps improve your comfort during cancer treatment.

This service was performed 210 times for 17 patients

Injection, pegfilgrastim, excludes biosimilar, 0.5 mg

Pegfilgrastim is a medication given via injection to stimulate the production of white blood cells. It's used to prevent infections after chemotherapy. This specific dose is 0.5 mg, and it's not a biosimilar, meaning it's the original, not a copy.

This service was performed 180 times for 12 patients

Injection, pembrolizumab, 1 mg

Pembrolizumab is a medication given via injection to help your body's immune system fight certain types of cancer. It's typically administered in a hospital or clinic by a healthcare professional.

This service was performed 9,002 times for 31 patients

Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromise

Tixagevimab and cilgavimab injection is a preventive treatment for certain adults and children (12+ years, weighing 40kg+) with compromised health conditions. It's used when there's no known exposure to SARS-CoV-2, to help their bodies better fend off potential infections.

This service was performed 18 times for 18 patients

Irrigation of implanted venous access drug delivery device

Irrigation of an implanted venous access drug delivery device is a procedure to clean or unblock the device. This device is implanted under your skin to allow easy, frequent, and long-term access to your veins for medication delivery. The process involves flushing the device with a sterile solution to ensure it works properly.

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 20 times for 20 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 18 times for 18 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 32 times for 23 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 15 times for 15 patients

Telephone or internet assessment with written report by consulting physician, 5 minutes or more

This service involves a consulting physician assessing your health condition via a phone or internet interaction. The doctor will spend at least 5 minutes discussing your health concerns. Afterwards, a written report summarizing the findings and recommendations will be provided for your reference.

This service was performed 17 times for 17 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $42.15 for a new patient copayment and $24.5 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 85259 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 78.58, 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: 78.58 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: 69.05

  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: 100

  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: 59.56

  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: 59.56

  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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