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Revenue Code (RC) 0420 Fee Schedule

Last Verified: January 2026

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.

General

Key FactDetail
Service Type

Physical Therapy

Complexity LevelModerate

National average reimbursement for Revenue Code 0420 by major payers:

bcbs

$411.98

uhc

$80.74

aetna

$221.00

cigna

$129.96

Preview provider-level rates for...
For billing codeRC 0420
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for RC 0420

United
0420$60.001700854288 - LAMB HEALTHCARE CENTER752388515 - (TX) LAMB HEALTHCARE CENTERTXGeneral Acute Care Hospital (282N00000X)
United
0420$441.001255684460 - INOVA HEALTH CARE SERVICES, INOVA ALEXANDRIA HOSPITAL540620889 - INOVA HEALTH CARE SERVICESVAGeneral Acute Care Hospital (282N00000X)
United
0420$131.001447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY720708111LAGeneral Acute Care Hospital (282N00000X)
United
0420$426.001922139120 - INOVA HEALTH CARE SERVICES, INOVA MOUNT VERNON HOSPITAL540620889 - INOVA HEALTH CARE SERVICESVAGeneral Acute Care Hospital (282N00000X)
United
0420$78.001215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
0420$116.001972517365 - COVENANT MEDICAL CENTER822913146 - (TX) COVENANT MEDICAL CENTERTXGeneral Acute Care Hospital (282N00000X)
United
0420$91.001801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISHLAGeneral Acute Care Hospital (282N00000X)
United
0420$60.001376540153 - ACADIA-ST. LANDRY HOSPITAL SERVICE DISTRICT, ACADIA-ST. LANDRY HOSPITAL720643190LACritical Access Hospital (282NC0060X)
United
0420$267.001659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LPTXGeneral Acute Care Hospital (282N00000X)
United
0420$417.001568593440 - INOVA HEALTH CARE SERVICES, INOVA FAIRFAX HOSPITAL540620889 - INOVA HEALTH CARE SERVICESVAMagnetic Resonance Imaging (MRI) Clinic/Center (261QM1200X)
United
0420$128.001376591941 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER726015227LAGeneral Acute Care Hospital (282N00000X)
United
0420$130.001831183748 - HOMER MEMORIAL HOSPITAL, CLAIBORNE MEMORIAL MEDICAL CENTER720396868 - (LA) HOMER MEMORIAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
0420$287.001942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICESTXGeneral Acute Care Hospital (282N00000X)
United
0420$397.001144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL760246499 - (TX) TOPS SPECIALTY HOSPITAL LTDTXGeneral Acute Care Hospital (282N00000X)
United
0420$121.001295718450 - CENTRASTATE MEDICAL CENTER, INC221750190 - (NJ) CENTRASTATE MEDICAL CENTER INCNJGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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Revenue Code 0420 vs. Other Physical Therapy Codes

The Revenue Code 0420 code is part of the Physical Therapy services . 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 Revenue Code 0420 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.

CodeComplexityDescription
0420-RCModerateGeneral
0421-RCModerateVisit charge

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including Revenue Code 0420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 0420 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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