Information and Policies
William James Brooks, DO
Board Certified - Osteopathic Manipulative Medicine

My goal is to provide you with the finest personalized and complete care in my specialty.  It is my intention to help you resolve your complaint(s) on an enduring basis.  Frank and open communication is essential to achieving that goal in the most efficient and effective manner.  If at any time you have questions or concerns regarding my services and / or policies, please bring them to my attention.

  1. Prior to your first visit please:

  2. Please bring with you to the first visit:

  3. Please wear loose fitting clothing for all visits.  Female patients should not wear girdles, dresses, or skirts.  They should wear slacks or shorts.

  4. Patients under the age of eighteen must be accompanied by a parent or guardian throughout each visit.  They should be under the concurrent care of a pediatrician or family physician.

  5. Please do not bring children requiring supervision to the appointment, as they are likely to significantly compromise the value of the visit.

  6. My services are scheduled to enable both personal and time-intensive care.  Please notify me as soon as you know that you will be unable to keep an appointment.

  7. Your initial visit will last approximately 120 minutes (2 hours) or longer.  Routine follow-up appointment times will last approximately 25 to 55 minutes (1/2 to 1 hour). Visit times will usually be less for pre-school and infant children.

Fees and billing 

  1. Fees vary as determined by the specific services provided at each visit.

  2. Payment may be made by check or debit / credit card. Checks are preferred. Payment is due at the time services are rendered. A receipt that contains all the information required from Dr. Brooks for submission to your insurance company will be provided at the time of service. Exceptions are noted in paragraphs 3 & 6.

  3. For Medicare patients:  Effective 4-1-15 I am (Dr. Brooks is) "opted out" of Medicare Part B insurance until at least 3-31-17. Patients who have Medicare Part B coverage - whether "traditional" or "advantage" plans - are welcome to receive my services. However, payment for services will no longer be provided by Medicare, and it is unlikely that a "secondary" insurer would provide payment. Neither I (Dr. Brooks) on your behalf, nor you (the patient) may submit a claim to the Medicare administrator for reimbursement. A contract must be signed at the time of your first visit signifying your understanding and acceptance of full financial responsibility for services rendered unless and until I (Dr. Brooks) "opts in" again to Medicare Part B.

    For Tricare patients: fees are the same as for Medicare patients. Payment in full is required at the time services are rendered; however, a patient covered by Tricare may submit a claim for insurance reimbursement. If Tricare coverage is secondary to Medicare Part B, then Tricare may not provide coverage. Each Tricare patient must also sign a waiver agreeing to pay my bill in full, even if the Tricare administrator processes the claim in a manner inconsistent with my bill.

    For Medical Student patients: fees are the same as for Medicare patients and Tricare patients. Payment is required at the time of service.
    DISCOUNTED Fee schedule for Medicare, Tricare, and Medical Student Patients   Effective 4-1-15
    CPT    Fee
      Outpatient Evaluation and Management  
    99205-25 New, Comprehensive - High (50-65 min) $230
    99204-25 New, Comprehensive - Moderate (35-50 min) $180
    99203-25 New, Detailed (25-35 min) $130
    99202-25 New - Expanded (15-25 min) $080
    99215-25 Established, Comprehensive (35-45 min) $160
    99214-25 Established, Detailed (20-35 min) $120
    99213-25 Established, Expanded (10-20 min) $080
    99212-25 Established, Focused (5-10 min) $040
    99354-25  Prolonged services (>30 <45 min)  $100
    99354-25 Prolonged services (>45 <60min)  $150
    99354-25  Prolonged services (>60 <75 min)  $200
    99355-25  Prolonged services (>75 - each additional 30 min)  $100
    99358-25  Prolonged services - case review (>30 <45 min)  $100
     

    Outpatient Procedures

     
    98925 Osteopathic Manipulation (1-2 regions) $040
    98926 Osteopathic Manipulation (3-4 regions) $055
    98927 Osteopathic Manipulation (5-6 regions) $070
    98928 Osteopathic Manipulation (7-8 regions) $085
    98929 Osteopathic Manipulation (9-10 regions) $100
    97110 Therapeutic exercise $040
    97112 Neuromuscular re-education $040
    97116 Gait training $040
      Other services  
    99080 Special reports $080 per 15 minutes
    99075 Medical testimony - including travel time $650 first hour or less; prorated thereafter

  4. 2015  ESTIMATED fee ranges for MEDICARE, TRICARE, and Medical Student patients:
               New patient -  from $265 to $595 (commonly ~ $450)
               Established patient -  from $120 to $300 (commonly ~ $210)

  5. For non-Medicare, non-Tricare, and non-Medical Student patients: due to the length of time spent with each patient and the specialized nature of my services, I do not contract with any private (HMO or PPO) insurance plans. In other words, I am an "out of network" or "out of plan" provider. 

  6. If you have been in an accident or have HMO coverage, I will accept payment directly from an insurance company, if and only if I receive advance written notice from the insurer that they will promptly pay my bills IN FULL in accordance with my fee schedule.  I do not accept liens. I do not accept patients covered by Workman's Compensation insurance.

  7. Estimated fee ranges for non-Medicare, non-Tricare, and non-Medical Student patients pre-school age:
    New patient -  for approximately 45 - 60 minute visit: usually between $220 and $460 (most commonly $315 99203-25; 98927).
    Established patient -  for approximately 30-45 minute visit:  usually between $200 and $300 (commonly $250 99213-25; 98927).

  8. Estimated fee ranges for non-Medicare, non-Tricare, and non-Medical Student patients older than pre-school age:
    New patient -  for approximately 2 hour visit: usually between $575 and $725 (most commonly $650
    99205-25; 99354-25; 98927; 97112).
    Established patient -  for approximately 45-55 minute visit: usually between $275 and $375 (most commonly $300
    99214-25; 98927).

  9. Itemized statements, medical records, and / or medical reports will be released to third parties only upon your written authorization and advance payment by the requesting party for each of these services. Each patient will receive, upon their signed authorization, ONE copy of their medical record for no charge.

  10. I am available to consult with your attorney and to provide medical testimony.  Each of these services will be provided upon advance payment by your attorney.

Fee schedule except as noted above *Initial visit at the request of and with a report to another physician Effective 4-1-15
CPT    Fee
  Outpatient Evaluation and Management  
99245-25 *Consult, Comprehensive - High (65-85 min)   $385
99244-25 *Consult, Comprehensive - Moderate (45-65 min) $320
99243-25 *Consult - Detailed (35-45 min) $255
99242-25 *Consult - Expanded (25-35) $190
99205-25 New, Comprehensive - High (50-65 min) $315
99204-25 New, Comprehensive - Moderate (35-50 min) $250
99203-25 New, Detailed (25-35 min) $185
99202-25 New - Expanded (15-25 min) $120
99215-25 Established, Comprehensive (35-45 min) $220
99214-25 Established, Detailed (20-35 min) $170
99213-25 Established, Expanded (10-20 min) $120
99212-25 Established, Focused (5-10 min) $070
99354-25  Prolonged services (>30 <45 min)  $130
99354-25 Prolonged services (>45 <60min)  $195
99354-25  Prolonged services (>60 <75 min)  $260
99355-25  Prolonged services (>75 - each additional 30 min)  $130
99358-25  Prolonged services - case review (>30 <45 min)  $130
 

Outpatient Procedures

 
98925 Osteopathic Manipulation (1-2 regions) $100
98926 Osteopathic Manipulation (3-4 regions) $115
98927 Osteopathic Manipulation (5-6 regions) $130
98928 Osteopathic Manipulation (7-8 regions) $145
98929 Osteopathic Manipulation (9-10 regions) $160
97110 Therapeutic exercise $065
97112 Neuromuscular re-education $065
97116 Gait training $065
  Other services  
99080 Special reports $080 per 15 minutes
99075 Medical testimony - including travel time $650 first hour or less; prorated thereafter

Please review my Privacy Policy

Thank you for your careful attention to these policies and procedures.


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