COURY JOHN CLEMENS PA
NPI 1609137249
Physician Assistant in Sherman Oaks, CA

Medicare Participation & PECOS Enrollment Status

Coury Clemens is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Coury Clemens 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: 143476242

  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: I20120806000353

  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? Maybe

  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.

Fluoroscopic guidance for insertion or removal of central vein access device

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

This service was performed 21 times for 21 patients

Insertion of central venous tube with port (5 years or older)

A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.

This service was performed 19 times for 19 patients

Insertion of tunneled central venous tube for infusion (5 years or older)

The insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.

This service was performed 14 times for 13 patients

Insertion of tunneled central venous tube for infusion (5 years or older)

The insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.

This service was performed 38 times for 35 patients

Leg revascularization (restoring blood flow)

Leg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.

This service was performed for 1-10 patients

Removal of plaque and insertion of stents in arteries of leg

This procedure, known as angioplasty, involves a small tube being inserted into your leg artery. The tube has a tiny balloon that inflates to remove plaque blocking the artery. A stent (a small mesh tube) is then placed to keep the artery open, improving blood flow.

This service was performed 31 times for 27 patients

Removal of plaque in arteries of leg

This procedure, known as atherectomy, involves clearing out plaque buildup in the leg arteries. Plaque can restrict blood flow, causing discomfort and potential health issues. A special device is inserted into the artery to carefully remove the plaque, improving blood circulation.

This service was performed 72 times for 57 patients

Removal of plaque in artery of leg, each additional vessel

This procedure involves eliminating plaque buildup in your leg arteries to improve blood flow. If more than one vessel is affected, each additional vessel will also be treated in the same session. This can help alleviate symptoms and prevent serious complications.

This service was performed 22 times for 21 patients

Removal of plaque in artery of leg, initial vessel

This procedure involves removing plaque from the initial vessel in your leg. Plaque, a build-up of fat, cholesterol, and other substances, can block blood flow. The removal process, known as an angioplasty, restores healthy blood circulation in your leg.

This service was performed 111 times for 80 patients

Ultrasonic guidance for blood vessel access

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

This service was performed 24 times for 23 patients

Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel

An ultrasound evaluation of a blood vessel is a non-invasive procedure that uses sound waves to create images of your blood vessels. A radiologist reviews these images to check for any abnormalities. If additional vessels need reviewing, the process is repeated.

This service was performed 209 times for 69 patients

Ultrasound evaluation of blood vessel with review by radiologist, initial vessel

This procedure involves using ultrasound, a safe imaging technique, to examine your blood vessels. The images are then reviewed by a radiologist, a doctor specialized in medical imaging. The process helps identify any abnormalities in your initial vessel.

This service was performed 104 times for 80 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 91403 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 100, 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: 100 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: 81.63

  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: 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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