HCPCS A9555 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | High |
National average reimbursement for HCPCS A9555 by major payers:
$1,116.39
$529.02
$386.36
$493.64
| 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 A9555 | ||||||
United | A9555 | $520.75 | 1083603401 - MARTIN ALDRICH | 201729166 - (FL) ALDRICH CARDIOVASCULAR | FL | Cardiovascular Disease Physician (207RC0000X) |
United | A9555 | $520.75 | 1689202574 - OSMAN ISMAEEL | 923211874 - (FL) HARBOR PHYSICIANS LLC | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $390.55 | 1447242268 - ABBAS RABIEI, MD | 201054138 - (FL) COASTAL NEPHROLOGY & HYPERTENSIO | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1023080363 - MOHAMMAD MUNIR | 463979554 - (FL) PIONEER MEDICAL GROUP, PL | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1912011511 - R K VISHEN MD P A | 510444005 - (FL) R K VISHEN, MD, PA | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1790913382 - SIVA MOHAN KROTHAPALLI | 591917016 - TALLAHASSEE MEMORIAL HEALTHCARE INC | FL | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | A9555 | $520.75 | 1952606683 - GEORGE IBRAHEIM | 873606124 - (FL) NARAYANA HEALTHCARE ALLIANCE LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | A9555 | $520.75 | 1508952862 - KEITH SWANSON | 590637874 - MARTIN MEMORIAL MEDICAL CENTER INC | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1285632265 - EDGAR WILLARD | 590724462 - (FL) WINTER HAVEN HOSPITAL INC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | A9555 | $494.70 | 1457340101 - MANOUCHER MANOUCHERI | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1417261611 - AYHAM MOUAWAD | 204676655 - (FL) AHMAD B AMAWI PA | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1942515804 - 30 MINUTE MEDICAL PRIMARY CARE, 30 MIN. MEDICAL, LLC | 260669832 | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1336103167 - WAGUIH EL MASRY | 200747230 - (FL) WAGUIH EL MASRY MD PA | FL | Internal Medicine Physician (207R00000X) |
United | A9555 | $520.75 | 1659790665 - OLADELE FABUNMI | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | A9555 | $520.75 | 1750464004 - VISHAL SHARMA | 651144413 - (FL) CENTER FOR MEDICINE INC | FL | Internal Medicine Physician (207R00000X) |
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 A9555 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9555 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 A9555 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 |
|---|---|---|
| A9554-HCPCS | Moderate | Iodine I-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries |
| A9555-HCPCS | High | Rubidium Rb-82, diagnostic, per study dose, up to 60 millicuries |
| A9556-HCPCS | Low | Gallium Ga-67 citrate, diagnostic, per millicurie |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9555 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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