Dr. Ross F Prochnow , MD
Pediatrics • Austin, TX
4515 Seton Center Pkwy #220
Austin, TX 787595784
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on July 29, 2006; this date does not establish years in practice.
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Published CMS data list 104 Original Medicare Part B services in 2021.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021. Published rows only; this is not a quality measure.
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Published Part B service records, 2021:
- U0003 — Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r: 37 service units.
- U0005 — Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within: 36 service units.
- 99212 — Established patient outpatient office visit: 16 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2020 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2021). CPT notice
See all 4 records in the table · Guide: How to read Medicare Part B data
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Medicare Part B services went from 80 in 2020 to 104 in 2021.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2021.
Practice Location & Contact Primary Location
4515 Seton Center Pkwy #220
Austin, TX 787595784
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Pediatrics: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $6,021 in 2021
The total amount Medicare approved for these services in 2021. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.
Paid by Medicare
About $4,971 in 2021
The part of the Medicare-allowed amount that Medicare itself paid in 2021, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2019–2025.
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Prochnow has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Prochnow as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Austin and Texas
Billing and prescribing volume is not a quality rating.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Dr. Prochnow are from 2021.
469 active clinicians are listed under Pediatrics with a practice address in Austin, TX (5,642 in Texas).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Austin
0% of these 469 clinicians have the CMS telehealth indicator.
8.5% of these 469 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services increased 30% from 80 in 2020 to 104 in 2021.
- 2020: 80
- 2021: 104
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Medicare-allowed amount
Medicare-allowed amount decreased 15% from $7,094 in 2020 to $6,021 in 2021.
- 2020: $7,094
- 2021: $6,021
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Paid by Medicare
Paid by Medicare decreased 29% from $7,018 in 2020 to $4,971 in 2021.
- 2020: $7,018
- 2021: $4,971
Sources: CMS Medicare Physician & Other Practitioners (2021), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2019–2020 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2020–2021; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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U0003
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
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37 | 31 | $134.00 | $75.00 |
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U0005
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within
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36 | 30 | $45.00 | $25.00 |
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99212
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
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16 | 15 | $88.00 | $58.40 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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15 | 15 | $131.00 | $94.12 |
Source: CMS Part B by Provider and Service, 2021; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 208000000X
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
NUCC Taxonomy Code: 207Q00000X
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - PEDIATRIC MEDICINE
I20040414001221
TX
5890789432
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Family Medicine
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Osteopathic Medicine (D.O.)
Internal Medicine
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated July 29, 2006.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Other Pediatrics Specialists in Austin
- Dr. Sharon Leong, MD
- Dr. Suzanne Vanbenthuysen, MD
- Dr. Boris Gritzka, MD
- Dr. Anne Mahan, MD
- Dr. Scott Broberg, MD
- Dr. Arti Lal, MD
Mailing Address
Po Box 26726
Austin, TX 787550726
Phone: 5124078686