HCPCS A9552 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 | • Administrative, Miscellaneous and Investigational • Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
National average reimbursement for HCPCS A9552 by major payers:
$363.33
$364.63
$350.92
$672.11
| 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 A9552 | ||||||
United | A9552 | $359.04 | 1316957368 - PING CHU | 760264063 | TX | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $359.04 | 1508809252 - DANIEL WILLIAMS | 351972384 - PARKVIEW HEALTH SYSTEM INC | IN | Medical Oncology Physician (207RX0202X) |
United | A9552 | $441.26 | 1265929723 - AMERICAN ONCOLOGY PARTNERS, P.A. | 824681345 | MI | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $359.04 | 1851355119 - RADIATION MEDICINE ASSOCIATES | 351853758 - (IN) RADIATION MEDICINE ASSOCIATES, P.C. | IN | Radiation Oncology Physician (2085R0001X) |
United | A9552 | $359.04 | 1932123205 - FADI HAYEK | 351092610 - (IN) HANCOCK REGIONAL HOSPITAL | IN | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $394.95 | 1265929723 - AMERICAN ONCOLOGY PARTNERS, P.A. | 824681345 | VA | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $426.91 | 1962848507 - ANDREW O'BRIEN | 351183155 - (IN) UNIVERSITY MEDICAL DIAGNOSTIC ASSOCIATES INC | IN | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $359.04 | 1093743551 - MARGARET COPLIN | 382027689 - ALLEGIANCE HEALTH | MO | Medical Oncology Physician (207RX0202X) |
United | A9552 | $359.04 | 1912922824 - JULIE FORSTNER | 300501592 - (MI) WEST MICHIGAN RADIATION ONCOLOGY | IN | Radiation Oncology Physician (2085R0001X) |
United | A9552 | $520.61 | 1396936225 - SRIKANTH TAMMA | 10211494 - CENTRAL MAINE MEDICAL CENTER | LA | Medical Oncology Physician (207RX0202X) |
United | A9552 | $359.04 | 1841710613 - MANASI GODBOLE | 205392766 - COMMUNITY PHYSICIANS OF INDIANA INC | IN | Medical Oncology Physician (207RX0202X) |
United | A9552 | $362.64 | 1588626576 - CRYSTAL REED | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | IN | Radiation Oncology Physician (2085R0001X) |
United | A9552 | $359.04 | 1790878726 - JUDITH WOLF | 205392766 - COMMUNITY PHYSICIANS OF INDIANA INC | IN | Gynecologic Oncology Physician (207VX0201X) |
United | A9552 | $359.04 | 1295706646 - ANITA CONTE | 351522595 - (IN) INDIANA COMMUNITY CANCER CARE, INC. | IN | Hematology & Oncology Physician (207RH0003X) |
United | A9552 | $448.80 | 1396772117 - FAROOQ AKBAR | 560529945 | SC | Medical Oncology Physician (207RX0202X) |
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 A9552 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9552 code is part of the Administrative, Miscellaneous and Investigational services used for Diagnostic and Therapeutic Radiopharmaceuticals. 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 A9552 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 |
|---|---|---|
| A9551-HCPCS | Moderate | Technetium Tc-99m succimer, diagnostic, per study dose, up to 10 millicuries |
| A9552-HCPCS | Moderate | Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 millicuries |
| A9553-HCPCS | Moderate | Chromium Cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9552 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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