KHOREN HEKIMIAN DO
NPI 1588695423
Family Medicine in Troup, TX

Medicare Participation & PECOS Enrollment Status

Khoren Hekimian 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.

Khoren Hekimian 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: 8628988003

  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: I20040914000431

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) (HCPCS:A4314)

  5 DME suppliers used 92 Medicare Claims 92 Services Paid

• DME-Orthotic Devices (DF000N)

  Urinary catheter anchoring device, adhesive skin attachment, each (HCPCS:A4333)

  4 DME suppliers used 74 Medicare Claims 721 Services Paid

• DME-Orthotic Devices (DF000N)

  Urinary catheter anchoring device, leg strap, each (HCPCS:A4334)

  4 DME suppliers used 52 Medicare Claims 52 Services Paid

• DME-Orthotic Devices (DF000N)

  Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

  5 DME suppliers used 119 Medicare Claims 142 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, powder, per oz (HCPCS:A4371)

  2 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)

  3 DME suppliers used 22 Medicare Claims 376 Services Paid

• DME-Orthotic Devices (DF000N)

  Tracheostomy care kit for established tracheostomy (HCPCS:A4629)

  3 DME suppliers used 33 Medicare Claims 928 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier, wipes or swabs, each (HCPCS:A5120)

  3 DME suppliers used 50 Medicare Claims 2260 Services Paid

• DME-Orthotic Devices (DF000N)

  Tracheostomy tube collar/holder, each (HCPCS:A7526)

  3 DME suppliers used 61 Medicare Claims 1507 Services Paid

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Tape, waterproof, per 18 square inches (HCPCS:A4452)

  4 DME suppliers used 70 Medicare Claims 10672 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive remover, wipes, any type, each (HCPCS:A4456)

  3 DME suppliers used 40 Medicare Claims 1860 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Collagen based wound filler, dry form, sterile, per gram of collagen (HCPCS:A6010)

  5 DME suppliers used 53 Medicare Claims 1705 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)

  5 DME suppliers used 58 Medicare Claims 994 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each (HCPCS:A6022)

  3 DME suppliers used 12 Medicare Claims 204 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)

  5 DME suppliers used 145 Medicare Claims 5237 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing (HCPCS:A6197)

  3 DME suppliers used 35 Medicare Claims 1165 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6203)

  2 DME suppliers used 61 Medicare Claims 1219 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)

  4 DME suppliers used 103 Medicare Claims 1068 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6219)

  3 DME suppliers used 41 Medicare Claims 1312 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6222)

  4 DME suppliers used 19 Medicare Claims 516 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6242)

  3 DME suppliers used 15 Medicare Claims 432 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Hydrogel dressing, wound filler, gel, per fluid ounce (HCPCS:A6248)

  4 DME suppliers used 18 Medicare Claims 75 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)

  4 DME suppliers used 42 Medicare Claims 1693 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

  2 DME suppliers used 22 Medicare Claims 2760 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

  5 DME suppliers used 70 Medicare Claims 7992 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6449)

  1 DME suppliers used 14 Medicare Claims 1295 Services Paid

• DME-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

  6 DME suppliers used 67 Medicare Claims 67 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

  3 DME suppliers used 26 Medicare Claims 26 Services Paid

• DME-Other DME (DE000N)

  Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Other DME (DE000N)

  Iv pole (HCPCS:E0776)

  5 DME suppliers used 94 Medicare Claims 94 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  3 DME suppliers used 36 Medicare Claims 36 Services Paid

• DME-Wheelchairs (DD021N)

  General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)

  3 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  9 DME suppliers used 116 Medicare Claims 126 Services Paid

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

  Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

  4 DME suppliers used 42 Medicare Claims 42 Services Paid

Unknown

• Other-Enteral and Parenteral (OB006N)

  Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

  7 DME suppliers used 181 Medicare Claims 5168 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)

  4 DME suppliers used 78 Medicare Claims 36693 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4152)

  7 DME suppliers used 95 Medicare Claims 46253 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4154)

  2 DME suppliers used 15 Medicare Claims 6156 Services Paid

• Other-Enteral and Parenteral (OB005N)

  Enteral nutrition infusion pump, any type (HCPCS:B9002)

  5 DME suppliers used 11 Medicare Claims 11 Services Paid

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 custodial care facility, group care, or assisted living visit, typically 25 minutes

This refers to a routine medical visit for an established patient living in a group care facility, custodial care, or assisted living. The visit typically lasts 25 minutes and includes a check-up and discussion about ongoing healthcare needs.

This service was performed 49 times for 17 patients

Follow-up nursing facility visit per day, typically 15 minutes

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

This service was performed 6,109 times for 1,024 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 1,266 times for 723 patients

Initial nursing facility visit per day, typically 35 minutes

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

This service was performed 595 times for 595 patients

Nursing facility annual assessment, typically 30 minutes

An annual assessment at a nursing facility is a routine check-up that typically lasts about 30 minutes. It's a chance for healthcare professionals to evaluate your overall health and wellness, monitor any ongoing conditions, and adjust care plans as needed.

This service was performed 249 times for 249 patients

Nursing facility discharge day management, 30 minutes or less

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

This service was performed 25 times for 25 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $24.26 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 75789 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 7.75, 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: 7.75 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: 0

  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: 25.86

  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: 25.86

  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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Khoren Hekimian is affiliated with the following medical facilities:

Reviews for KHOREN HEKIMIAN DO

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