SEAN MICHAEL FAHEY M.D.
NPI 1619976479
Internal Medicine - Rheumatology in Mooresville, NC

Medicare Participation & PECOS Enrollment Status

Sean Fahey 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.

Sean Fahey 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: 2264416239

  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: I20040616001130

  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 chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 299 times for 54 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 229 times for 37 patients

Blood creatinine level

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

This service was performed 231 times for 105 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 23 times for 14 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

This service was performed 369 times for 127 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 76 times for 47 patients

Creatine kinase (cardiac enzyme) level, total

The total Creatine Kinase (CK) level test is a blood test that helps assess the health of your heart. It measures an enzyme called CK that's released into the bloodstream when heart or other muscle tissue is damaged. High levels may indicate a heart attack or muscle disorder.

This service was performed 60 times for 50 patients

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 26 times for 26 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 247 times for 79 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 593 times for 289 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 274 times for 154 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 281 times for 67 patients

Infusion, normal saline solution, 250 cc

An infusion of normal saline solution, 250 cc, involves administering a sterile saltwater solution into your body through a vein, usually in your arm. This helps to replenish fluids, maintain hydration, and balance electrolytes in your body.

This service was performed 539 times for 95 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 196 times for 69 patients

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.

This service was performed 14,975 times for 32 patients

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.

This service was performed 32,400 times for 13 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 4,560 times for 48 patients

Injection, golimumab, 1 mg, for intravenous use

Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

This service was performed 10,300 times for 17 patients

Injection, infliximab, excludes biosimilar, 10 mg

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

This service was performed 7,910 times for 30 patients

Injection, tocilizumab, 1 mg

Tocilizumab is a medication administered via injection. It's used to treat certain conditions like rheumatoid arthritis by reducing inflammation in the body. It works by blocking a substance in the body that leads to inflammation.

This service was performed 38,360 times for 13 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 82 times for 13 patients

Injection, zoledronic acid, 1 mg

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

This service was performed 100 times for 20 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 622 times for 254 patients

Liver function blood test panel

A liver function blood test panel helps check the health of your liver. It measures various proteins, liver enzymes, and bilirubin in your blood. If these levels are too high or too low, it could signal a liver problem. It's a simple, non-invasive test that involves drawing blood.

This service was performed 420 times for 137 patients

Measurement c-reactive protein for detection of infection or inflammation

C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.

This service was performed 380 times for 202 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 74 times for 74 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 40 times for 40 patients

Red blood cell sedimentation rate, to detect inflammation, automated

The Red Blood Cell Sedimentation Rate is a test that helps detect inflammation in the body. It's automated, meaning a machine does the work. This test measures how fast red blood cells settle at the bottom of a tube in an hour. A faster rate may indicate inflammation.

This service was performed 556 times for 235 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 12 times for 12 patients

X-ray of foot, 2 views

An X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.

This service was performed 11 times for 11 patients

X-ray of hand, 2 views

An X-ray of the hand, 2 views, is a non-invasive imaging test that uses a small amount of radiation to produce pictures of the bones in your hand. Two different angles are captured to provide a comprehensive view. This helps in diagnosing injuries or conditions affecting your hand.

This service was performed 38 times for 38 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $23.98 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 28117 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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