DR. RINAL PATEL MD
NPI 1982918025
Internal Medicine in Houston, TX

Medicare Participation & PECOS Enrollment Status

Rinal Patel 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.

Rinal Patel 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: 345475554

  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: I20171027000933

  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-Hospital Beds (DB000N)

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

  1 DME suppliers used 69 Medicare Claims 69 Services Paid

• DME-Other DME (DE000N)

  Nebulizer, with compressor (HCPCS:E0570)

  2 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Other DME (DE000N)

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

  3 DME suppliers used 15 Medicare Claims 19 Services Paid

• DME-Wheelchairs (DD000N)

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

  2 DME suppliers used 11 Medicare Claims 22 Services Paid

• DME-Wheelchairs (DD021N)

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

  3 DME suppliers used 13 Medicare Claims 25 Services Paid

• DME-Other DME (DE000N)

  Transport chair, adult size, patient weight capacity up to and including 300 pounds (HCPCS:E1038)

  3 DME suppliers used 24 Medicare Claims 24 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)

  2 DME suppliers used 23 Medicare Claims 23 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Portable oxygen concentrator, rental (HCPCS:E1392)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD021N)

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

  2 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Wheelchairs (DD021N)

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

  2 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  3 DME suppliers used 91 Medicare Claims 91 Services Paid

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  2 DME suppliers used 36 Medicare Claims 36 Services Paid

• DME-Wheelchairs (DD021N)

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

  2 DME suppliers used 28 Medicare Claims 28 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 15 minutes

This is a routine 15-minute visit for patients residing in care facilities like nursing homes or assisted living. During this visit, healthcare providers review the patient's health, manage medications, and address any concerns or changes in condition. It ensures continuous, quality care.

This service was performed 41 times for 20 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 86 times for 36 patients

Extended inpatient or observation hospital service, first hour

This service involves staying in the hospital for a longer period for close monitoring or treatment. During the first hour, medical staff observe your health status, administer necessary treatments, and ensure your comfort and safety. It's part of ensuring optimal care.

This service was performed 22 times for 18 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 44 times for 30 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 114 times for 51 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 338 times for 124 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 267 times for 65 patients

Follow-up nursing facility visit per day, typically 35 minutes

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

This service was performed 74 times for 51 patients

Follow-up nursing facility visit per day, typically 35 minutes

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

This service was performed 36 times for 25 patients

Initial nursing facility visit per day, typically 45 minutes

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

This service was performed 91 times for 88 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 28 times for 28 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 15 times for 15 patients

Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow

This service involves a physician overseeing your care while you receive Medicare-covered services from a home health agency. The care you're receiving is complex and involves various disciplines. The physician isn't physically present but regularly supervises your treatment to ensure optimal health outcomes.

This service was performed 20 times for 13 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.51 for a new patient copayment and $25.67 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 77008 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.

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. Rinal Patel is affiliated with the following medical facilities:

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