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See a sample rate comparisonHCPCS A9520 Fee Schedule
HCPCS A9520 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
Technetium Tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $462.28 median of the 7 states in the free preview · View Medicaid rates for A9520 |
National average reimbursement for HCPCS A9520 by major payers:
$612.81
BCBS / Anthem
$764.35
UnitedHealthcare
$683.98
Aetna
$552.69
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A9520.
HCPCS A9520
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$1,984.72Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$799.45Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$754.20Published rateMonroe Hma, LLC, Clearview Regional Medical Center
Monroe Hma LLC
$754.20Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$674.81Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9520 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9520. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A9517-HCPCS | Low | Iodine I-131 sodium iodide capsule(s), therapeutic, per millicurie |
| A9520-HCPCS | Moderate | Technetium Tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries |
| A9521-HCPCS | High | Technetium Tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9520 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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