HCPCS A4223 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 | • Medical And Surgical Supplies • Injection and Infusion Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS A4223 by major payers:
$61.60
$3.56
$22.69
$42.94
| 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 HCPCS A4223 | ||||||
United | A4223 | $0.01 | 1831304633 - WEST TEXAS REHABILITATION CENTER | 750868320 - THE WEST TEXAS REHABILITATION CENTER | TX | Hearing Instrument Specialist (237700000X) |
United | A4223 | $68.73 | 1558449603 - VICTORIA NWOSU | 470765154 - ALEGENT CREIGHTON CLINIC | TX | Neurology Physician (2084N0400X) |
United | A4223 | $0.01 | 1275683823 - JEFFREY HALLETT | 742798880 - CERTIFIED ALLERGY ASTHMA OF SAN ANTONIO PA | TX | Allergy & Immunology Physician (207K00000X) |
United | A4223 | $0.01 | 1780023044 - AYESHA ZUBERI | 452419394 | TX | Infectious Disease Physician (207RI0200X) |
United | A4223 | $0.01 | 1780023044 - AYESHA ZUBERI | 452419394 | TX | Infectious Disease Physician (207RI0200X) |
United | A4223 | $68.73 | 1851668115 - LAXMI KOKATNUR | 470765154 - ALEGENT CREIGHTON CLINIC | TX | Neurology Physician (2084N0400X) |
United | A4223 | $0.01 | 1831304633 - WEST TEXAS REHABILITATION CENTER | 750868320 - THE WEST TEXAS REHABILITATION CENTER | TX | Hearing Instrument Specialist (237700000X) |
United | A4223 | $0.01 | 1831304633 - WEST TEXAS REHABILITATION CENTER | 750868320 - THE WEST TEXAS REHABILITATION CENTER | TX | Multi-Specialty Group (193200000X) |
United | A4223 | $0.01 | 1831304633 - WEST TEXAS REHABILITATION CENTER | 750868320 - THE WEST TEXAS REHABILITATION CENTER | TX | Multi-Specialty Group (193200000X) |
United | A4223 | $1000000.00 | 1386796191 - SPENCER MILLER | 1386796191 - SPENCER MILLER | TX | Neurology Physician (2084N0400X) |
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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HCPCS A4223 vs. Other Injection and Infusion Supplies Codes
The HCPCS A4223 code is part of the Medical And Surgical Supplies services used for Injection and Infusion Supplies. 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 A4223 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 |
|---|---|---|
| A4222-HCPCS | Low | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
| A4223-HCPCS | Low | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
| A4224-HCPCS | Low | Supplies for maintenance of insulin infusion catheter, per week |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4223. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4223 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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