Insurance Information:

​Dr. Pearle participates in several insurance plans and is currently accepting new patients.  You may not have a choice in your health benefits, but you do have a choice in quality and the educated care that Dr. Pearle and his support staff provide.  Even if Dr. Pearle is not an "in-network" provider, most patients are still able to see him in an "out-of-network" capacity. Our team will assist with benefit investigation so that you are aware of any potential fees.  We firmly believe financial roadblocks should not interfere with your choice of quality patient care.

When you call for an appointment, please have your insurance card readily accessible.  Your exam with Dr. Pearle is billed by our own billing office, as Dr. Pearle is a private physician within HSS.  Dr. Pearle participates with United Healthcare, Oxford, BCBS, Cigna, Emblem & The Empire Plan.  Dr. Pearle is opted out of Medicare.  We do not accept No Fault or Workers Compensation.  The fee for Dr. Pearle’s office visit (CPT 99203) is $450, this is the amount billed to your insurance plan, and the amount you could potentially owe for your office visit if you do not have insurance coverage.

Even if you have an insurance plan that Dr. Pearle may generally accept, we recommend all patients call their insurance company and speak with a representative to verify your benefits and whether Dr. Pearle is a participating provider in your plan.  Your insurance company can tell you this if you give them Dr. Pearle's NPI# 142 707 1778 (individual) or 128 586 6392 (group).​  

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Radiology Billing at HSS:

Your x-rays will be performed by and billed by Hospital for Special Surgery.  If you would like to confirm whether HSS is in-network, you can do this by calling your insurance and providing the hospital’s NPI # 159 870 3019.  You may also contact the HSS Insurance Advisory Dept. at HSS at (212) 774-2607, and they will verify whether the hospital is in-network with your plan.   In order to provide you with potential out-of-pocket costs, a CPT code must be provided to Insurance Advisory.  Please see below for the most commonly ordered x-ray views, ask our staff to confirm which x-rays Dr. Pearle will order for you.  Unfortunately, our office cannot answer any questions about radiology fees, these must be directed to Insurance Advisory. 

CPT 73564 - AP, Lateral, PA Flex Weight Bearing & Merchant View of the knee

CPT 77077 - Bilateral Hip-to-Ankle view