HCPCS A4617 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 • Respiratory Supplies and Equipment |
| Complexity Level | Low |
National average reimbursement for HCPCS A4617 by major payers:
$3.55
$2.39
$2.86
$5.54
| 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 A4617 | ||||||
United | A4617 | $2.30 | 1942975412 - KRISTINA MARTINEZ | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Audiologist (231H00000X) |
United | A4617 | $1.96 | 1932127347 - KELLE HARRISON | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Audiologist (231H00000X) |
United | A4617 | $1.96 | 1083718456 - DARSIT SHAH | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NJ | Otology & Neurotology Physician (207YX0901X) |
United | A4617 | $1.96 | 1881981587 - JENNIFER HARTMAN | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Audiologist (231H00000X) |
United | A4617 | $2.18 | 1356693790 - DANIELLE CARDINALI | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NY | Speech-Language Pathologist (235Z00000X) |
United | A4617 | $2.30 | 1801932454 - HECTOR RODRIGUEZ | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Otolaryngology Physician (207Y00000X) |
United | A4617 | $2.34 | 1457645707 - MENA ABRAHIM | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NJ | Otolaryngology/Facial Plastic Surgery Physician (207YX0905X) |
United | A4617 | $63.00 | 1255319034 - JAY HOROWITZ | 223322428 | NJ | Chiropractor (111N00000X) |
United | A4617 | $1.96 | 1770522807 - MICHAEL TOM | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Otolaryngology Physician (207Y00000X) |
United | A4617 | $2.30 | 1548622798 - OMAR WAQAR | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Allergy & Immunology Physician (207K00000X) |
United | A4617 | $2.18 | 1578929691 - ELVERA BADER | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NY | Audiologist-Hearing Aid Fitter (237600000X) |
United | A4617 | $1.96 | 1376629147 - KENNETH KAPLAN | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NJ | Otolaryngology Physician (207Y00000X) |
United | A4617 | $2.23 | 1831138304 - GARY FISHMAN | 590973502 - MEMORIAL HEALTH SYSTEMS INC | NY | Otolaryngology Physician (207Y00000X) |
United | A4617 | $2.30 | 1568803369 - NICOLE DORNICIK | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Audiologist (231H00000X) |
United | A4617 | $1.96 | 1376582924 - STEVEN KASE | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Otolaryngology Physician (207Y00000X) |
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 A4617 vs. Other Respiratory Supplies and Equipment Codes
The HCPCS A4617 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 A4617 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 |
|---|---|---|
| A4616-HCPCS | Low | Tubing (oxygen), per foot |
| A4617-HCPCS | Low | Mouth piece |
| A4618-HCPCS | Low | Breathing circuits |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4617. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4617 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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