Medicare Enrolled
Dr. Tushar Modi, M.D.
Internal Medicine · Modesto, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Speaking/Promotional
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Modi from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
Are you Dr. Modi?
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What this data tells you about Dr. Modi
Dr. Tushar Modi is an internal medicine specialist in Modesto, CA, with 20 years of NPI registration. Based on federal Medicare data, Dr. Modi performed 7,056 Medicare services across 4,056 unique beneficiaries.
Between the years covered by Open Payments, Dr. Modi received a total of $632 from 8 pharmaceutical and/or device companies across 19 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. The majority of payments are for speaking programs and promotional activities, reflecting participation in industry-sponsored events. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Modi is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 20 years in practice
▲ Top 4% volume in CA
$632 industry payments
Medicare Practice Summary
Medicare Utilization ↗7,056
Medicare services
Top 4% in CA for internal medicine
4,056
Unique beneficiaries
$52
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~353 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
1,437 | $65 | $145 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
707 | $51 | $100 |
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
559 | $39 | $86 |
| Annual alcohol misuse screening, 5 to 15 minutes | 515 | $19 | $40 |
| Annual depression screening | 498 | $19 | $40 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
470 | $135 | $193 |
| Destruction of precancerous skin growths, 2-14 This procedure involves the removal or destruction of two to fourteen precancerous skin lesions. It is performed to eliminate abnormal skin cells that have the potential to develop into cancer. |
250 | $5 | $15 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
243 | $100 | $198 |
| Remote vital sign monitoring management, each additional 20 minutes This code covers the time spent by a provider managing patient data from remote vital sign monitoring devices. It applies to each additional 20-minute increment beyond the initial monthly service period. |
229 | $32 | $66 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
222 | $32 | $50 |
| Influenza vaccine, quadrivalent, 0.5 ml dosage | 219 | $20 | $35 |
| Obesity behavioral counseling, 15 minutes A 15-minute face-to-face session focused on behavioral counseling to help manage obesity. |
196 | $26 | $45 |
| Office visit, established patient (10-19 min) An office visit for an existing patient lasting 10 to 19 minutes. The visit involves medical evaluation and management of the patient's condition. |
192 | $36 | $90 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
155 | $11 | $31 |
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
145 | $40 | $80 |
| Vitamin B-12 injection An injection of vitamin B-12 (cyanocobalamin) with a dose of up to 1000 mcg. |
137 | $1 | $5 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
132 | $230 | $417 |
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
106 | $42 | $92 |
| Advance care planning consultation, first 30 min A session focused on discussing and documenting future healthcare preferences and goals. This service covers the initial 30 minutes of the planning discussion. |
86 | $66 | $150 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
77 | $12 | $50 |
| Destruction of precancerous skin growth, 1 Removal of a single precancerous skin growth. This procedure destroys abnormal skin cells to prevent them from developing into cancer. |
75 | $48 | $110 |
| New patient office visit, complex (60-74 min) | 59 | $167 | $339 |
| Home health plan of care certification Certification by a physician or allowed practitioner for Medicare-covered home health services under a home health plan of care. This includes contacting the home health agency and reviewing reports of patient status required by physicians. |
59 | $42 | $90 |
| Ear wax removal by washing This procedure involves the removal of impacted ear wax using a washing technique. |
53 | $12 | $35 |
| Chronic care management, first 30 minutes This service covers the initial 30 minutes of care coordination for patients with two or more chronic conditions. It is provided personally by a healthcare professional each calendar month. |
37 | $70 | $135 |
| Injection, methylprednisolone acetate, 40 mg | 33 | $6 | $20 |
| Joint injection, major joint Removal of fluid from a large joint and/or injection of medication into the joint space. |
27 | $47 | $150 |
| Home health plan of care re-certification A physician reviews the patient's status and contacts the home health agency to re-certify the plan of care without the patient being present. |
27 | $35 | $70 |
| Remote physiologic monitoring setup and education Initial setup of remote monitoring equipment and patient education on its use. |
24 | $16 | $40 |
| Ear wax removal A procedure to remove impacted ear wax from the ear canal. |
19 | $32 | $100 |
| Smoking cessation counseling, 4-10 minutes A brief counseling session focused on helping patients quit smoking and tobacco use. The provider spends 4 to 10 minutes discussing strategies and support for cessation. |
19 | $14 | $30 |
| Transitional care management services, moderate complexity Services provided to coordinate care during the transition from an inpatient or other facility setting back to the community. This includes follow-up and management of a health problem of at least moderate complexity. |
19 | $168 | $325 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
17 | $172 | $270 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
13 | $106 | $260 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Industry Payment Transparency
Open Payments through 2024 ↗$632
Total received (2018-2024)
Avg $126/year across 5 years
Top 42% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
8
Companies
19
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$478 (75.6%)
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$154 (24.4%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$309
2023
$98
2021
$63
2019
$125
2018
$36
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Astellas Pharma US Inc
$250
Lilly USA, LLC
$33
GlaxoSmithKline, LLC.
$14
PFIZER INC.
$13
Top 3 companies account for 95.7% of 2024 payments
All-time payments by company (2018-2024) ›
Astellas Pharma US Inc
$348
GENZYME CORPORATION
$90
Allergan Inc.
$48
SANOFI-AVENTIS U.S. LLC
$40
Lilly USA, LLC
$33
GlaxoSmithKline, LLC.
$26
PFIZER INC.
$24
Sunovion Pharmaceuticals Inc.
$23
Top 3 companies account for 76.9% of all-time payments
Associated products mentioned in payments ›
ANORO · BYSTOLIC · CHANTIX · GEMTESA · LASTACAFT · LINZESS · MOUNJARO · PREVNAR 20 · SOLIQUA 100/33 · TOUJEO · TRELEGY ELLIPTA
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
The majority of payments (76%) are for speaking programs and promotional activities, which reflect participation in industry-sponsored educational or marketing events. This is common in internal medicine and does not inherently indicate bias, but patients may wish to be aware.
Geographic Context
Internal medicine physicians within 10 mi
277
Per 100K population
50.2
County median income
$79,661
Nearest hospital
DOCTORS MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Modi is a clinical cardiology specialist, with above-average Medicare volume (top 4% in CA), with speaking/promotional industry engagement, with 20 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Modi experienced with office visit, established patient (20-29 min)?
Based on Medicare claims data, Dr. Modi performed 1,437 office visit, established patient (20-29 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Modi receive payments from pharmaceutical companies?
Yes. Dr. Modi received a total of $632 from 8 companies across 19 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Modi's costs compare to other internal medicine physicians in Modesto?
Dr. Modi's average Medicare payment per service is $52. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Modi) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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