DR. TODD MICHAEL RALEIGH M.D.
NPI 1396061339
Psychiatry & Neurology - Neurology in Bellingham, WA

Medicare Participation & PECOS Enrollment Status

Todd Raleigh 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.

Todd Raleigh 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: 5092027532

  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: I20150711000054

  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 by technician, first 30 minutes

This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.

This service was performed 12 times for 12 patients

Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)

Continuous intraoperative neurophysiology monitoring is a service where a specialist oversees your nervous system's function during surgery, from a nearby or remote location. This is done every 15 minutes and is focused solely on you. It helps ensure surgical safety by identifying any potential nervous system changes promptly.

This service was performed 770 times for 213 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 12 times for 12 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 258 times for 177 patients

Evaluation of neuropsychological test, first hour

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

This service was performed 24 times for 24 patients

Measurement of brain wave activity (eeg) outside the brain during surgery

An EEG (Electroencephalogram) during surgery monitors brain activity. Electrodes on the scalp record brain wave patterns, helping doctors ensure the brain is functioning normally throughout the procedure.

This service was performed 14 times for 14 patients

Needle measurement of electrical activity in arm or leg muscles, 2 extremities

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. It helps diagnose conditions affecting nerves or muscles. It's generally painless, though you may feel some discomfort.

This service was performed 63 times for 63 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 66 times for 61 patients

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study

This procedure, known as an electromyography (EMG), involves using a needle to measure electrical activity in your muscles. It can help diagnose conditions affecting nerves or muscles. It's a limited study, meaning only specific muscles in the arm, leg, trunk, or head are examined.

This service was performed 208 times for 100 patients

Nerve conduction, 5-6 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.

This service was performed 38 times for 38 patients

Nerve conduction, 7-8 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps doctors identify nerve damage. In a 7-8 study procedure, 7-8 specific nerves are tested. You may feel a mild, brief tingling or shock during the test.

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 128 times for 128 patients

Placement of skin electrodes and measurement of central motor stimulation in arms and legs

This procedure involves placing small patches (electrodes) on your skin over your arms and legs. These electrodes send harmless electrical signals to your muscles. The response is measured to assess the health and function of your nerves and muscles.

This service was performed 102 times for 101 patients

Placement of skin electrodes and measurement of stimulated sites on arms and legs

This procedure involves placing small pads (electrodes) on your arms and legs. These electrodes send gentle electric signals to specific areas, and the responses are measured. This helps assess the health of your nerves and muscles.

This service was performed 212 times for 211 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 $25.19 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 98226 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.

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