HCPCS A4596 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 • Various Medical Supplies Including Tapes and Surgical Dressings |
| Complexity Level | Low |
National average reimbursement for HCPCS A4596 by major payers:
$47.76
$24.58
$30.38
$41.21
| 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 A4596 | ||||||
United | A4596 | $77.55 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A4596 | $22.90 | 1861478851 - CLINCH COUNTY HOSPITAL AUTHORITY | 586011853 - (GA) CLINCH COUNTY HOSPITAL AUTHORITY | GA | Critical Access Hospital (282NC0060X) |
United | A4596 | $75.34 | 1962461681 - PIEDMONT HOSPITAL, INC, PIEDMONT HOSPITAL | 580566213 - (GA) PIEDMONT HEALTHCARE INC | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $22.90 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A4596 | $53.00 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $75.34 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $20.80 | 1417157405 - EMORY HEALTHCARE | 711018941 - CARDIAC ARRHYTHMIA INSTITUTE | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $22.90 | 1033191267 - STEPHENS COUNTY HOSPITAL AUTHORITY | 586001667 - (GA) STEPHENS COUNTY HOSPITAL AUTHORITY | GA | Rural Acute Care Hospital (282NR1301X) |
United | A4596 | $22.90 | 1245248624 - HOSPITAL AUTHORITY OF BEN HILL, DORMINY MEDICAL CENTER | 581157005 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A4596 | $21.14 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | A4596 | $75.34 | 1780638833 - CARTERSVILLE MEDICAL CENTER LLC, CARTERSVILLE MEDICAL CENTER | 582433438 - (GA) CARTERSVILLE MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $50.40 | 1851768337 - KELLY RIDGES | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
United | A4596 | $75.34 | 1285663856 - ROCKDALE MEDICAL CENTER INC., ROCKDALE HOSPITAL | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A4596 | $17.34 | 1134259328 - BORBAS SURGICAL SUPPLY, INC | 113568895 - (NY) BORBAS SURGICAL SUPPLY INC | NY | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | A4596 | $31.72 | 1770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL | 586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIA | GA | Critical Access Hospital (282NC0060X) |
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 A4596 vs. Other Various Medical Supplies Including Tapes and Surgical Dressings Codes
The HCPCS A4596 code is part of the Medical And Surgical Supplies services used for Various Medical Supplies Including Tapes and Surgical Dressings. 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 A4596 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 |
|---|---|---|
| A4595-HCPCS | Low | Electrical stimulator supplies, 2 lead, per month, (e.g., TENS, NMES) |
| A4596-HCPCS | Low | Cranial electrotherapy stimulation (ces) system supplies and accessories, per month |
| A4600-HCPCS | Low | Sleeve for intermittent limb compression device, replacement only, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4596. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4596 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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