HCPCS A7003 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 • Breathing Aids |
| Complexity Level | Low |
National average reimbursement for HCPCS A7003 by major payers:
$3.63
$1.77
$1.63
$2.50
| 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 A7003 | ||||||
United | A7003 | $0.88 | 1851771786 - RYAN LOK | 570978524 - (SC) LOWCOUNTRY LUNG AND CRITICAL CARE P.A. | IN | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | A7003 | $1.72 | 1093087611 - RICHARD MCNEILLY | 550477361 - (WV) BOONE MEMORIAL HOSPITAL INC | TN | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.13 | 1093592644 - ANSIBLE HEALTH MEDICAL GROUP PA | 883238466 | IA | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $0.75 | 1093087611 - RICHARD MCNEILLY | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | SC | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.09 | 1992090229 - ROPER HOSPITAL, INC., CENTER FOR SPINAL CORD INJURY | 570828733 - ROPER HOSPITAL INC | SC | Physical Medicine & Rehabilitation Physician (208100000X) |
United | A7003 | $1.15 | 1407204233 - THOMAS WHITTON | 411806657 - (MN) CENTRACARE CLINIC | KS | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.07 | 1053360198 - CHARLESTON PULMONARY ASSOCIATES PA | 570938227 - (SC) CHARLESTON PULMONARY ASSOCIATES PA | SC | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.14 | 1013112614 - CHRISTY SINE | 134290167 - ST FRANCIS PHYSICIAN SERVICES INC | SC | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.59 | 1093087611 - RICHARD MCNEILLY | 550477361 - (WV) BOONE MEMORIAL HOSPITAL INC | WV | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.13 | 1093592644 - ANSIBLE HEALTH MEDICAL GROUP PA | 883238466 | NV | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $0.87 | 1912347857 - CATHERINE MILLENDER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $3.88 | 1730122375 - ZOTHANMAWII KHIANGTE | 141338544 - SAMARITAN HOSPITAL | NY | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.21 | 1467956177 - SHAWN ESPERTI | 852276567 - LEXINGTON HEALTH INC | SC | Pulmonary Disease Physician (207RP1001X) |
United | A7003 | $1.09 | 1508864968 - SOLA KIM | 570828733 - ROPER HOSPITAL INC | SC | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | A7003 | $1.73 | 1700897048 - KENNETH KALASSIAN | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | PA | Pulmonary Disease Physician (207RP1001X) |
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 A7003 vs. Other Breathing Aids Codes
The HCPCS A7003 code is part of the Medical And Surgical Supplies services used for Breathing Aids. 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 A7003 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 |
|---|---|---|
| A7002-HCPCS | Low | Tubing, used with suction pump, each |
| A7003-HCPCS | Low | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
| A7004-HCPCS | Low | Small volume nonfiltered pneumatic nebulizer, disposable |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7003. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7003 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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