DR. JAY H. ROSENBERG M.D.
NPI 1609804848
Psychiatry & Neurology - Neurology in La Jolla, CA

Medicare Participation & PECOS Enrollment Status

Jay Rosenberg 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.

Jay Rosenberg 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: 1850371329

  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: I20040723001036

  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.

Durable Medical Equipment

• DME-Other DME (DE000N)

  Commode chair, mobile or stationary, with detachable arms (HCPCS:E0165)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Other DME (DE000N)

  Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty (HCPCS:E0181)

  1 DME suppliers used 46 Medicare Claims 46 Services Paid

• DME-Hospital Beds (DB000N)

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

  2 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Hospital Beds (DB000N)

  Mattress, foam rubber (HCPCS:E0272)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress (HCPCS:E0295)

  1 DME suppliers used 87 Medicare Claims 88 Services Paid

• DME-Hospital Beds (DB000N)

  Bed side rails, full length (HCPCS:E0310)

  1 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Other DME (DE000N)

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

  1 DME suppliers used 21 Medicare Claims 21 Services Paid

• DME-Other DME (DE000N)

  Patient lift, electric with seat or sling (HCPCS:E0635)

  1 DME suppliers used 32 Medicare Claims 33 Services Paid

• DME-Other DME (DE000N)

  Trapeze bars, a/k/a patient helper, attached to bed, with grab bar (HCPCS:E0910)

  1 DME suppliers used 37 Medicare Claims 37 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, tray, each (HCPCS:E0950)

  2 DME suppliers used 57 Medicare Claims 57 Services Paid

• DME-Wheelchairs (DD000N)

  Heel loop/holder, any type, with or without ankle strap, each (HCPCS:E0951)

  7 DME suppliers used 76 Medicare Claims 151 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each (HCPCS:E0953)

  4 DME suppliers used 74 Medicare Claims 142 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)

  12 DME suppliers used 155 Medicare Claims 155 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)

  4 DME suppliers used 42 Medicare Claims 42 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each (HCPCS:E0956)

  6 DME suppliers used 14 Medicare Claims 22 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware (HCPCS:E0960)

  4 DME suppliers used 37 Medicare Claims 37 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, wheel lock brake extension (handle), each (HCPCS:E0961)

  5 DME suppliers used 59 Medicare Claims 118 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)

  9 DME suppliers used 74 Medicare Claims 148 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each (HCPCS:E0973)

  11 DME suppliers used 86 Medicare Claims 172 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, positioning belt/safety belt/pelvic strap, each (HCPCS:E0978)

  7 DME suppliers used 65 Medicare Claims 65 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, push-rim activated power assist system (HCPCS:E0986)

  5 DME suppliers used 26 Medicare Claims 27 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction (HCPCS:E1007)

  12 DME suppliers used 139 Medicare Claims 139 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each (HCPCS:E1012)

  11 DME suppliers used 131 Medicare Claims 131 Services Paid

• DME-Wheelchairs (DD021N)

  Residual limb support system for wheelchair, any type (HCPCS:E1020)

  1 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)

  12 DME suppliers used 252 Medicare Claims 460 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)

  9 DME suppliers used 132 Medicare Claims 175 Services Paid

• DME-Wheelchairs (DD000N)

  Manual adult size wheelchair, includes tilt in space (HCPCS:E1161)

  7 DME suppliers used 318 Medicare Claims 318 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each (HCPCS:E1225)

  2 DME suppliers used 212 Medicare Claims 218 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches (HCPCS:E2201)

  2 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches (HCPCS:E2203)

  2 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, pneumatic propulsion tire, any size, each (HCPCS:E2211)

  4 DME suppliers used 32 Medicare Claims 64 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each (HCPCS:E2213)

  4 DME suppliers used 32 Medicare Claims 64 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, foam propulsion tire, any size, each (HCPCS:E2218)

  1 DME suppliers used 23 Medicare Claims 45 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, foam caster tire, any size, each (HCPCS:E2219)

  2 DME suppliers used 53 Medicare Claims 104 Services Paid

• DME-Wheelchairs (DD021N)

  Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware (HCPCS:E2231)

  2 DME suppliers used 26 Medicare Claims 26 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware (HCPCS:E2311)

  12 DME suppliers used 138 Medicare Claims 138 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each (HCPCS:E2313)

  12 DME suppliers used 139 Medicare Claims 139 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated (HCPCS:E2323)

  1 DME suppliers used 31 Medicare Claims 31 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) (HCPCS:E2359)

  3 DME suppliers used 82 Medicare Claims 162 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) (HCPCS:E2361)

  9 DME suppliers used 46 Medicare Claims 92 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) (HCPCS:E2363)

  9 DME suppliers used 24 Medicare Claims 47 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) (HCPCS:E2365)

  4 DME suppliers used 17 Medicare Claims 34 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue (HCPCS:E2377)

  12 DME suppliers used 140 Medicare Claims 140 Services Paid

• DME-Wheelchairs (DD021N)

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

  5 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

  Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2607)

  10 DME suppliers used 81 Medicare Claims 81 Services Paid

• DME-Wheelchairs (DD021N)

  General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware (HCPCS:E2611)

  8 DME suppliers used 29 Medicare Claims 29 Services Paid

• DME-Wheelchairs (DD021N)

  Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware (HCPCS:E2620)

  8 DME suppliers used 110 Medicare Claims 110 Services Paid

• DME-Wheelchairs (DD021N)

  Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth (HCPCS:E2622)

  3 DME suppliers used 63 Medicare Claims 63 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  2 DME suppliers used 28 Medicare Claims 28 Services Paid

• DME-Wheelchairs (DD000N)

  Ultralightweight wheelchair (HCPCS:K0005)

  8 DME suppliers used 38 Medicare Claims 38 Services Paid

• DME-Wheelchairs (DD021N)

  Adjustable angle footplate, each (HCPCS:K0040)

  9 DME suppliers used 117 Medicare Claims 223 Services Paid

• DME-Wheelchairs (DD021N)

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

  4 DME suppliers used 198 Medicare Claims 200 Services Paid

• DME-Other DME (DE000N)

  Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes (HCPCS:K0739)

  5 DME suppliers used 16 Medicare Claims 110 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds (HCPCS:K0821)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds (HCPCS:K0823)

  3 DME suppliers used 90 Medicare Claims 92 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds (HCPCS:K0825)

  2 DME suppliers used 21 Medicare Claims 21 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds (HCPCS:K0841)

  7 DME suppliers used 41 Medicare Claims 41 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds (HCPCS:K0861)

  9 DME suppliers used 81 Medicare Claims 81 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 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 37 times for 19 patients

Evaluation for wheelchair, each 15 minutes

This procedure involves assessing your physical needs and capabilities to determine the most suitable wheelchair for you. It takes into account your comfort, mobility, and lifestyle requirements. Each session lasts 15 minutes.

This service was performed 350 times for 174 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 312 times for 312 patients

Physician service required to establish and document the need for a power mobility device

This service involves your doctor assessing your mobility needs. They'll document your condition, verify if a power mobility device (like a motorized wheelchair) could improve your life quality, and provide the required medical records to insurance for coverage.

This service was performed 298 times for 296 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.05 for a new patient copayment and $27.1 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 92037 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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