Insurance & Billing
Modal Pain Management accepts most major commercial PPO insurance plans for pain management consultations and interventional procedures. Benefits are verified before your first visit at no charge or obligation.
What Modal Pain Management Accepts
Modal Pain Management is a private interventional pain practice located at 369 Lexington Avenue, Floor 25, in Midtown East (NYC 10017). The practice accepts most major commercial PPO insurance plans for in-office consultations with Dr. Alex Movshis and for interventional procedures performed in our procedure suite — including epidural steroid injections, lumbar and cervical medial branch blocks, radiofrequency ablation, ultrasound-guided peripheral joint and nerve injections, trigger point injections, and BOTOX for chronic migraine.
Commercial Plans We Routinely Accept
- Aetna
- Anthem Blue Cross Blue Shield
- Blue Cross Blue Shield (BCBS)
- Cigna
- Empire Plan (NYS)
- Oscar Health
- Oxford
- UMR (UnitedHealthcare subsidiary)
- UnitedHealthcare
- Most other major commercial PPO networks
Plan-specific in-network status, deductible balance, and prior-authorization requirements are verified with your carrier directly before your first visit. The list above identifies carriers Modal Pain Management routinely works with — it is not a guarantee of in-network status for every plan or product within a carrier's portfolio. Verification confirms the specifics for your individual plan.
Coverage for any specific service depends on your individual plan's benefits, deductible status, in-network or out-of-network designation, and any prior-authorization requirements. Our billing team verifies these details with your carrier directly and provides a written benefits summary before any scheduled procedure.
Plans Not Accepted
Modal Pain Management does not currently accept Medicare or Medicaid. Patients with Medicare or Medicaid coverage should consult their plan's online directory or call their member services line for in-network pain management providers in the New York City area.
How Insurance Verification Works
Verification is a no-cost, no-obligation process designed to give you a clear picture of what your visit and any recommended procedures will cost — before you commit to scheduling.
- Submit your insurance information. Use the online verification form or call (646) 290-6660. We collect your member ID, group number, plan name, and date of birth.
- Our billing team contacts your carrier directly. We confirm your in-network or out-of-network status with Modal Pain Management, your remaining annual deductible, your coinsurance percentage, your copay obligation, and any plan-specific limits on pain management services.
- You receive a written benefits summary. The summary lists projected out-of-pocket cost for the consultation and for any commonly recommended procedures (epidural steroid injection, nerve block, RFA, trigger point injection). Most verifications complete within 1–2 business days.
- Schedule with confidence. Same-week appointments are routinely available. Verification runs in parallel and does not delay scheduling.
Out-of-Network Coverage
Many PPO plans include out-of-network benefits that reimburse a portion of the visit and procedure costs after the out-of-network deductible has been met. If Modal Pain Management is out-of-network for your specific plan, our team:
- Verifies your out-of-network deductible, allowed amount methodology, and coinsurance percentage with your carrier.
- Provides itemized superbills with all required CPT procedure codes and ICD-10 diagnosis codes after each visit and procedure.
- Documents Dr. Movshis's clinical findings to support medical necessity if your plan reviews the claim.
You submit the superbill directly to your insurance carrier for reimbursement. Most patients with out-of-network benefits recover a meaningful portion of their costs after deductible.
Procedure Prior Authorization
Most interventional pain procedures performed at Modal Pain Management require prior authorization from commercial insurance carriers. The procedures most commonly requiring prior auth include:
- Epidural steroid injections (cervical, thoracic, lumbar) — fluoroscopy-guided
- Medial branch blocks and lumbar/cervical facet joint injections
- Radiofrequency ablation (RFA) of the medial branch nerves
- Sacroiliac joint injections
- Genicular nerve blocks and genicular RFA
- BOTOX for chronic migraine (PREEMPT protocol)
- Spinal cord stimulator trial and implantation (when indicated)
After your consultation, Dr. Movshis prepares the supporting clinical documentation — diagnosis, conservative care history, imaging review, and treatment rationale — and our billing team submits the prior-authorization request to your carrier. Most authorizations are returned within 5–10 business days. We track each request and update you when approval is received so the procedure can be scheduled.
Payment Options
Modal Pain Management accepts:
- Cash and all major credit cards
- HSA (Health Savings Account) and FSA (Flexible Spending Account) cards
- Insurance assignment for in-network plans
- Self-pay with transparent, written pricing
Patient responsibility (copay, coinsurance, or any portion of the deductible owed) is collected at the time of service unless alternative arrangements have been made in advance.
Self-Pay Pricing
Self-pay rates for new-patient consultations and individual procedures are available on request. Modal Pain Management offers transparent, written self-pay pricing — including diagnostic injections — for patients without insurance, those whose plans don't cover the procedure, or those who prefer to pay directly to avoid deductibles. Call (646) 290-6660 for current rates.
Referrals
Most PPO plans do not require a referral to see Dr. Movshis. Some plans — particularly HMOs and certain employer-sponsored networks — do require a primary care referral before the visit will be covered. Our verification team confirms your specific plan's referral requirements during the verification step so there are no surprises.
Insurance & Billing FAQ
Direct, sourced answers to the most common insurance and billing questions from new patients.
Does Modal Pain Management accept insurance?
Yes. Modal Pain Management accepts most major commercial PPO insurance plans for pain management consultations and interventional procedures performed at our Midtown Manhattan office (369 Lexington Avenue, Floor 25, New York, NY 10017). Benefits are verified before your first visit at no charge or obligation.
Does Modal Pain Management accept Medicare or Medicaid?
No. Modal Pain Management does not currently accept Medicare or Medicaid. Patients with Medicare or Medicaid coverage should consult their plan for in-network pain management providers.
What insurance does a pain management doctor in NYC accept?
Coverage varies by physician and practice. At Modal Pain Management, Dr. Alex Movshis accepts most major commercial PPO plans, including Aetna, Anthem Blue Cross Blue Shield, Blue Cross Blue Shield, Cigna, Empire Plan (NYS), Oscar Health, Oxford, UMR, UnitedHealthcare, and most other major commercial networks. Coverage for specific procedures — epidural steroid injections, nerve blocks, radiofrequency ablation, trigger point injections, BOTOX for chronic migraine — depends on your individual plan's benefits, deductible, and any prior-authorization requirements. Our team verifies these details for you in advance. Modal Pain Management does not accept Medicare or Medicaid.
How does insurance verification work at Modal Pain Management?
Submit your insurance information through our verification form or by phone at (646) 290-6660. Our billing team contacts your carrier to confirm: (1) whether Modal Pain Management is in-network or out-of-network for your specific plan, (2) your deductible status and remaining balance, (3) coinsurance and copay obligations, and (4) any prior-authorization requirements for the specific procedures discussed. We send you a written benefits summary before scheduling — no surprises at the office.
What if Modal Pain Management is out-of-network for my plan?
Many PPO plans include out-of-network benefits that cover a portion of the visit and procedure costs after the out-of-network deductible is met. We provide itemized superbills with all required CPT and ICD-10 codes so you can submit for reimbursement directly to your insurance carrier. Our team explains your projected out-of-pocket cost in writing before your first visit.
Do interventional pain procedures need prior authorization?
Most interventional procedures — including epidural steroid injections, lumbar and cervical medial branch blocks, radiofrequency ablation, sacroiliac joint injections, and BOTOX for chronic migraine — require prior authorization from commercial insurance carriers. Modal Pain Management's billing team submits these requests with the supporting clinical documentation Dr. Movshis prepares after your consultation. Most authorizations are returned within 5–10 business days.
How much does a pain management consultation cost without insurance?
Self-pay rates for new-patient consultations at Modal Pain Management are quoted at the time of scheduling. Many of our procedures — including diagnostic injections — are also available on a self-pay basis with transparent, written pricing. Call (646) 290-6660 for current self-pay rates.
What forms of payment does Modal Pain Management accept?
Modal Pain Management accepts cash, all major credit cards, HSA/FSA cards, and insurance for covered services. Patient responsibility (copay, coinsurance, or remaining deductible) is collected at the time of service unless other arrangements have been made in advance.
Do I need a referral from my primary care doctor to see Dr. Movshis?
It depends on your insurance plan. Most PPO plans do not require a referral. Some plans — particularly HMOs and certain employer-sponsored plans — do require a primary care referral before the visit will be covered. Our verification team confirms your specific plan's referral requirements before your first visit.
How long does insurance verification take?
Most insurance verifications are completed within 1–2 business days. Same-week appointments are routinely available — verification does not delay scheduling. If your plan requires prior authorization for a specific procedure, that step happens after your consultation and adds 5–10 business days before the procedure can be performed.
Ready to Verify Your Benefits?
Send your insurance details through our secure verification form. Our billing team will contact your carrier and email you a written benefits summary within 1–2 business days — at no charge and no obligation.
Related Information
- About Dr. Alex Movshis, MD — board certifications, fellowship training, and verifiable credentials.
- Dr. Movshis's Credentials & Verification — board certification IDs, NPI, training program details.
- Treatments & Procedures — the full list of interventional pain procedures performed at the practice.
- Contact & Office Information — location, hours, parking, and accessibility.
- Book an Appointment — same-week availability for new patients.