THEODORE E WORKMAN JR. MD
NPI 1316970031
Pain Medicine - Interventional Pain Medicine in Redding, CA

Medicare Participation & PECOS Enrollment Status

Theodore Workman 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.

Theodore Workman 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: 5294736161

  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: I20070118000611

  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 psychological or neuropsychological test, first 30 minutes

This procedure involves a health professional conducting a psychological or neuropsychological test. The first 30 minutes typically involve understanding your mental health or brain function through various assessments. This helps in diagnosing and treating mental health disorders effectively.

This service was performed 86 times for 66 patients

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes

This service involves a structured assessment, such as AUDIT or DAST, to identify potential misuse of alcohol or substances. If misuse is detected, a brief intervention lasting 5-14 minutes is conducted to provide guidance and support to help manage the issue.

This service was performed 12 times for 12 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 38 times for 23 patients

Assessment of emotional or behavioral problems

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

This service was performed 24 times for 21 patients

Blood glucose (sugar) level

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

This service was performed 36 times for 23 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 212 times for 170 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 230 times for 187 patients

Destruction of peripheral nerve or branch

Destruction of a peripheral nerve or branch is a procedure to treat nerve-related pain. It involves using heat, cold, or chemicals to damage or destroy the nerve, thereby blocking pain signals to the brain. This can provide long-term pain relief.

This service was performed 32 times for 26 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves the use of imaging technology to accurately target and destroy nerves in the upper or middle spinal facet joints, which may be causing pain. Each additional facet joint treated follows the same process.

This service was performed 85 times for 65 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 105 times for 85 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 156 times for 95 patients

Injection of anesthetic agent and/or steroid into other nerve or branch

This procedure involves injecting an anesthetic agent or steroid into a specific nerve or its branch. The goal is to relieve pain by reducing inflammation and numbing the area. It is commonly used for chronic pain management. The process is safe and usually quick.

This service was performed 61 times for 20 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 25 times for 16 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

This service was performed 158 times for 114 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 418 times for 280 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

This service was performed 118 times for 83 patients

Injection of contrast for imaging of hip joint

This procedure involves injecting a contrast agent into your hip joint, which helps to highlight the joint structures in imaging tests. It aids in diagnosing conditions like arthritis or injury. You may feel slight discomfort during the injection, but it's generally safe.

This service was performed 21 times for 20 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 194 times for 128 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 228 times for 147 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 144 times for 106 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 151 times for 100 patients

Injection of upper or middle spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the upper or middle spine facet joint, a small joint in your back. This is done under imaging guidance for precision. It's a second-level procedure, meaning it's done on two separate joints. It can help reduce pain and inflammation.

This service was performed 94 times for 61 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 97 times for 63 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

This service was performed 2,067 times for 588 patients

Injection, clonidine hydrochloride, 1 mg

Clonidine hydrochloride is a medication given via injection. It's commonly used to manage high blood pressure. The 1 mg dosage refers to the amount of the active drug in the injection. Side effects may include dry mouth, drowsiness, or dizziness.

This service was performed 38 times for 37 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 1,915 times for 238 patients

Injection, fentanyl citrate, 0.1 mg

Fentanyl citrate is a potent pain medication administered via injection. The 0.1 mg dosage is used to manage severe pain conditions. It works by blocking pain signals to the brain. It's crucial to follow the dosage instructions to prevent potential side effects.

This service was performed 1,018 times for 479 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

This service was performed 281 times for 194 patients

Injection, midazolam hydrochloride, per 1 mg

Midazolam hydrochloride is a medication injected to help you relax or sleep before surgery or certain medical procedures. It works by calming the brain and nerves. It's given in small doses, measured in milligrams (mg).

This service was performed 766 times for 301 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 65 times for 11 patients

Injection, propofol, 10 mg

Propofol is a medication given via injection to help you relax or sleep during surgery or other medical procedures. The 10 mg dosage refers to the amount of medication you'll receive. It's administered by a healthcare professional and monitored closely for safety.

This service was performed 744 times for 381 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 600 times for 145 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 44 times for 18 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 15 times for 15 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 2,111 times for 518 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 109 times for 52 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 a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 1,021 times for 535 patients

Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes

This service involves a physician administering medication to lower your consciousness during a procedure. It's done for your comfort and safety. The drug's effects last about 15 minutes, so additional doses may be given as needed.

This service was performed 558 times for 271 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.48 for a new patient copayment and $25.84 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 96001 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 14.65, 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: 14.65 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: 25

  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: 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Reviews for THEODORE E WORKMAN JR. MD

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Frequently Asked Questions