ROHIT DAS
NPI 1801174677
Internal Medicine - Gastroenterology in Pittsburgh, PA

Medicare Participation & PECOS Enrollment Status

Rohit Das 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.

Rohit Das 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: 3577710607

  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: I20160823001981

  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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 34 times for 33 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

This service was performed 11 times for 11 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

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 15 times for 13 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 90 times for 85 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

This service was performed 24 times for 19 patients

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito

Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

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 18 times for 18 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 11 times for 11 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

This service was performed 20 times for 20 patients

Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope

This procedure involves a radiologist examining images from a tube placement in your bile and pancreatic duct. An endoscope, a flexible tube with a light and camera, is used to help guide this process. It assists in diagnosing and treating conditions related to these ducts.

This service was performed 14 times for 14 patients

Review by radiologist of image from tube placement into bile duct using an endoscope

This procedure involves a specialist, called a radiologist, examining an image taken during a tube placement into your bile duct. The tube is inserted with the help of a tool called an endoscope. This allows the doctor to check for any issues or abnormalities in your bile duct.

This service was performed 34 times for 31 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 112 times for 64 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves a flexible tube with a camera, called an endoscope, inserted through your mouth to examine your esophagus, stomach, and upper small bowel. An ultrasound device on the endoscope helps get detailed images. It's safe and helps diagnose various conditions.

This service was performed 11 times for 11 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth

This procedure involves a flexible tube with a camera and ultrasound device, inserted through the mouth to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like inflammation, tumors, or other abnormalities.

This service was performed 14 times for 14 patients

Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope

An ultrasound guided needle aspiration or biopsy of the esophagus involves using a flexible tube with a camera (endoscope) to view your esophagus. An ultrasound device on the endoscope helps to guide a needle to take a small tissue sample for testing. This is a safe, minimally invasive procedure.

This service was performed 13 times for 13 patients

Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using an ultrasound to guide a needle to specific areas in the esophagus, stomach, or upper small bowel. A flexible endoscope is used to reach these areas. The needle collects a small sample for testing.

This service was performed 12 times for 12 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.58 for a new patient copayment and $24.2 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 15213 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 77.5, 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: 77.5 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: 68.61

  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 comprises 40% of a provider's final MIPS score.
  
  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: 100

  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 comprises 25% of a provider's final MIPS score.
  
  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 comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: 56.4

  The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.

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. Rohit Das is affiliated with the following medical facilities:

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