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See a sample rate comparisonRevenue Code (RC) 0431 Fee Schedule
Last Verified: September 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.
Visit charge
| Key Fact | Detail |
|---|---|
| Service Type | Occupational Therapy |
| Complexity Level | Moderate |
National average reimbursement for Revenue Code 0431 by major payers:
$447.84
$84.32
$215.63
$132.03
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RC 0431
5 of 25 sample ratesHigher to lower in this preview
Children'S Hospital
Childrens Hospital Inc
$155.00Published rateSurgical Specialty Center Of Baton Rouge, LLC, Surgical Specialty Center Of Baton Rouge
Surgical Specialty Center Of Baton Rouge, LLC
$97.00Published rateLife Care Centers Of America, Inc., Life Care Center Of Winter Haven
Life Care Centers Of America, Inc.
$65.00Published rateOaks Of Kissimmee Operations LLC, Kissimmee Health And Rehabilitation Center
Oaks Of Kissimmee Operations LLC
$65.00Published rateAcadia-St. Landry Hospital Service District, Acadia-St. Landry Hospital
$60.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalRevenue Code 0431 vs. Other Occupational Therapy Codes
The Revenue Code 0431 code is part of the Occupational 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 0431 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including Revenue Code 0431. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0431 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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