CPT 0101T Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Category III Codes • Various Services - Category III Codes |
| Complexity Level | Moderate |
National average reimbursement for CPT 0101T by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 0101T | ||||||
United | 0101T | $5287.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $1328.00 | 1821250176 - NORTHSHORE AMBULATORY SURGERY CENTER LLC | 800352092 - (LA) NORTHSHORE AMBULATORY SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 0101T | $8267.00 | 1518924109 - TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1, TERREBONNE GENERAL MEDICAL CENTER | 720880258 - (LA) TERREBONNE HOSPITAL SERVICE DISTRICT NO 1 | LA | General Acute Care Hospital (282N00000X) |
United | 0101T | $6904.00 | 1033114608 - MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL, LLP, MEMORIAL HERMANN SURGICAL HOSPITAL FIRST COLONY | 352167462 - (TX) MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL LLP | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $159.39 | 1003898313 - MOREHOUSE GENERAL HOSPITAL | 726011528 - (LA) MOREHOUSE GENERAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 0101T | $213.52 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $184.55 | 1952538431 - METHODIST MCKINNEY HOSPITAL LLC | 208847736 - (TX) METHODIST MCKINNEY HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $8539.00 | 1295788735 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN SUGAR LAND HOSPITAL | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $5490.00 | 1255325817 - MIDLAND COUNTY HOSPITAL DISTRICT, MIDLAND MEMORIAL HOSPITAL | 751584559 - (TX) MIDLAND COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $364.83 | 1316505043 - ETHICUS HOSPITAL DFW LLC, LEGENT ORTHOPEDIC HOSPITAL | 263044485 - (TX) ETHICUS HOSPITAL DFW | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $5261.00 | 1982671491 - BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION, BAPTIST ST. ANTHONY'S HEALTH SYSTEM-BAPTIST CAMPUS | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $649.00 | 1992994115 - ST HELENA PARISH HOSPITAL | 720627145 - (LA) ST HELENA PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 0101T | $5428.00 | 1659559573 - ST LUKES COMMUNITY DEVELOPMENT CORPORATION, ST LUKES SUGAR LAND HOSPITAL | 261947374 - (TX) ST LUKES COMMUNITY DEVELOPMENT CORPORATION-SUGAR LAND | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $8320.00 | 1215296884 - TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE | 451502252 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE | TX | General Acute Care Hospital (282N00000X) |
United | 0101T | $387.10 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 0101T vs. Other Various Services - Category III Codes Codes
The CPT 0101T code is part of the Category III Codes services used for Various Services - Category III Codes. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 0101T code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 0101T-CPT | Moderate | Extracorporeal Shock Wave Involving Musculoskele- Tal System Not Otherwise Specified (Desc Rvsd 1/1/2022) (For Application Of Low Energy Musculoskeletal System Extracorporeal Shock Wave Use 0019t) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0101T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0101T fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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