HCPCS A4305 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 • Access Catheters and Drug Delivery Systems |
| Complexity Level | Low |
National average reimbursement for HCPCS A4305 by major payers:
$16.85
$6.86
$8.23
$12.52
| 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 A4305 | ||||||
United | A4305 | $5.31 | 1194015297 - SCOTTY ORTEGA MD LLP | 451561780 - SCOTTY ORTEGA, M.D., P.A., LLP | TX | Multi-Specialty Group (193200000X) |
United | A4305 | $5.31 | 1285635813 - HANS SANDER | 550853118 - CENTRAL TEXAS COMMUNITY HEALTH CENTERS | TX | Dermatology Physician (207N00000X) |
United | A4305 | $5.31 | 1285635813 - HANS SANDER | 550853118 - CENTRAL TEXAS COMMUNITY HEALTH CENTERS | TX | Dermatology Physician (207N00000X) |
United | A4305 | $8.80 | 1861996738 - KORY LEE | 562356367 - ADVANCED DERMATOLOGY AND SKIN CARE, PA | TX | Dermatology Physician (207N00000X) |
United | A4305 | $5.62 | 1073714200 - MUKHTAR ANEES | 586004467 - HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA | TX | Gastroenterology Physician (207RG0100X) |
United | A4305 | $10.28 | 1508091216 - CLEVELAND REGIONAL MEDICAL CENTER, LP | 593215798 - CLEVELAND REGIONAL MEDICAL CENTER LP | TX | Hospitalist Physician (208M00000X) |
United | A4305 | $10.28 | 1174738371 - PANHANDLE ANESTHESIA SERVICES LLP | 200422692 - PANHANDLE ANESTHESIA SERVICES LLP | TX | Anesthesiology Physician (207L00000X) |
United | A4305 | $5.31 | 1720242639 - HENRY JOSEPH LEGERE III MD PA | 262617682 - HENRY JOSEPH LEGERE, III, M.D., P.A. | TX | Multi-Specialty Group (193200000X) |
United | A4305 | $5.30 | 1821026352 - TEXAS HEALTH CARE, P.L.L.C. | 710892430 - TEXAS HEALTH CARE, P.L.L.C. | TX | Multi-Specialty Group (193200000X) |
United | A4305 | $5.59 | 1235402728 - DALLAS PULMONARY & CRITICAL CARE PA | 454323821 - DALLAS PULMONARY AND CRITICAL | TX | Multi-Specialty Group (193200000X) |
United | A4305 | $5.31 | 1598027880 - ERNESTO MALAVE MD PA | 455360202 - ERNESTO MALAVE MD PA | TX | Family Medicine Physician (207Q00000X) |
United | A4305 | $4.69 | 1013303080 - ACCESS TELECARE, PLLC | 462718719 - ACCESS TELECARE PLLC | TX | Internal Medicine Physician (207R00000X) |
United | A4305 | $5.63 | 1740214675 - DAYNA DIVEN | 264562522 - SETON FAMILY OF DOCTORS | TX | Dermatology Physician (207N00000X) |
United | A4305 | $5.59 | 1891221636 - VEDA MEDICAL, LLC | 820991324 - VEDA MEDICAL LLC | TX | Plastic and Reconstructive Surgery Physician (2086S0122X) |
United | A4305 | $5.59 | 1649833351 - ALFONSO BARNARD BARRAGAN, MD PA | 262938672 - ALFONSO BARNARD BARRAGAN MD PA | TX | Surgery of the Hand (Surgery) Physician (2086S0105X) |
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 A4305 vs. Other Access Catheters and Drug Delivery Systems Codes
The HCPCS A4305 code is part of the Medical And Surgical Supplies services used for Access Catheters and Drug Delivery Systems. 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 A4305 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 |
|---|---|---|
| A4301-HCPCS | Moderate | Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.) |
| A4305-HCPCS | Low | Disposable drug delivery system, flow rate of 50 ml or greater per hour |
| A4306-HCPCS | Low | Disposable drug delivery system, flow rate of less than 50 ml per hour |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4305 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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