HCPCS A2005 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 | Matrix for Wound Management (Placental, Equine, Synthetic) |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A2005 |
National average reimbursement for HCPCS A2005 by major payers:
$179.39
$265.86
$199.38
$223.89
HCPCS A2005 vs. Other Matrix for Wound Management (Placental, Equine, Synthetic) Codes
The HCPCS A2005 code is part of the Matrix for Wound Management (Placental, Equine, Synthetic) 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 HCPCS A2005 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 |
|---|---|---|
| A2004-HCPCS | Low | Xcellistem, 1 mg |
| A2005-HCPCS | Low | Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure) |
| A2006-HCPCS | Low | Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A2005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A2005 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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