Revenue Code (RC) 0430 Fee Schedule

Revenue Code (RC) 0430 is classified under Occupational Therapy.

General

Key Fact	Detail
Service Type	Occupational Therapy
Complexity Level	Moderate

National average reimbursement for Revenue Code 0430 by major payers:

$412.78

BCBS / Anthem

$80.44

UnitedHealthcare

$214.76

Aetna

$129.73

Cigna

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RC 0430

5 of 25 sample ratesHigher to lower in this preview

Inova Health Care Services, Inova Loudoun Hospital
Inova Health Care Services
VAGeneral Acute Care HospitalNPI 1376564302Tax ID 54-0620889
$426.00Published rate
St Josephs University Medical Center Inc., St Josephs Hospital And Medical Center
St Josephs Health Inc
NJGeneral Acute Care HospitalNPI 1669462420Tax ID 22-1487602
$293.00Published rate
Capital Health System, Inc., Capital Health Medical Center - Hopewell
Capital Health System Inc
NJGeneral Acute Care HospitalNPI 1073516183Tax ID 22-3548695
$161.00Published rate
Maricopa County Special Health Care District, Valleywise Health
AZGeneral Acute Care HospitalNPI 1073576740Tax ID 86-0830701
$125.00Published rate
St Helena Parish Hospital, St Helena Parish Hospital
St Helena Parish Hospital
LACritical Access HospitalNPI 1013068808Tax ID 72-0627145
$65.00Published rate

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Payer Contract Negotiation

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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Revenue Code 0430 vs. Other Occupational Therapy Codes

The table lists codes related to 0430. Select one to see its fee schedule.

Code	Complexity	Description
0430-RC	Moderate	General
0431-RC	Moderate	Visit 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 0430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 0430 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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