HCPCS A4613 Fee Schedule

HCPCS A4613 vs. Other Respiratory Supplies and Equipment Codes

The HCPCS A4613 code is part of the Medical And Surgical Supplies services used for Respiratory Supplies and Equipment. 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 A4613 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 HCPCS A4613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4613 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.