DR. JOSEPH MORRIS GOOGE JR. M.D.
NPI 1366448672
Ophthalmology - Retina Specialist in Knoxville, TN

Medicare Participation & PECOS Enrollment Status

Joseph Googe 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

• 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 complete exam of visual system

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

This service was performed 623 times for 558 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 952 times for 521 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 299 times for 223 patients

Exam of retinal blood vessels using a special camera after injection of a dye

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

This service was performed 120 times for 120 patients

Imaging of retina

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

This service was performed 3,369 times for 1,122 patients

Injection of drug into eye

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

This service was performed 1,625 times for 325 patients

Injection, aflibercept, 1 mg

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

This service was performed 1,436 times for 115 patients

Injection, bevacizumab, 10 mg

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

This service was performed 135 times for 35 patients

Injection, dexamethasone, intravitreal implant, 0.1 mg

This procedure involves placing a tiny implant into your eye. This implant slowly releases a medication called dexamethasone, which helps to reduce inflammation and swelling in the eye, improving vision and comfort.

This service was performed 119 times for 11 patients

Injection, ranibizumab, 0.1 mg

Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.

This service was performed 4,237 times for 165 patients

New patient complete exam of visual system

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

This service was performed 143 times for 143 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 13 times for 13 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 76 times for 76 patients

Photography of the retina

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

This service was performed 15 times for 15 patients

Removal of eye fluid (vitreous) between lens and retina

This procedure, known as a vitrectomy, involves removing some or all of the vitreous humor, the clear gel-like substance in the eye. It's done to treat various eye conditions, like retinal detachment or macular hole. The aim is to improve or stabilize vision. It's performed under local or general anesthesia.

This service was performed 16 times for 14 patients

Removal of membrane of retina

Removal of the retina's membrane is a surgical procedure aimed at treating eye conditions affecting the retina's function. It involves a delicate operation to eliminate scar tissue or membranes causing vision problems. The procedure can help improve or stabilize vision.

This service was performed 12 times for 12 patients

Removal of membrane of retina with removal of internal limiting membrane of retina

This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.

This service was performed 18 times for 18 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

This service was performed 14 times for 13 patients

Unclassified biologics

Unclassified biologics are a type of treatment derived from living organisms. They can include a wide range of substances, such as vaccines, blood components, or genes, used to prevent or treat diseases. Each is specifically designed to interact with the body's natural defenses to promote healing.

This service was performed 39 times for 14 patients

Physician Visit Costs

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 37909 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 96.31, 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: 96.31 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: 97.12

  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: 93

  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: 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.

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