HCPCS A9558 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 | Low |
National average reimbursement for HCPCS A9558 by major payers:
$152.75
$280.49
$249.24
$189.47
| 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 A9558 | ||||||
United | A9558 | $276.95 | 1679845531 - DANA HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | A9558 | $276.95 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | A9558 | $290.80 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A9558 | $400.35 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | A9558 | $290.80 | 1629185285 - BACON COUNTY HEALTH SERVICES, INC. | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | A9558 | $564.59 | 1225050396 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL CHEROKEE | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A9558 | $227.11 | 1861895393 - KAYLA HANKS | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Family Nurse Practitioner (363LF0000X) |
United | A9558 | $227.11 | 1568462661 - JOHN RUCKER | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Pulmonary Disease Physician (207RP1001X) |
United | A9558 | $227.11 | 1548460744 - LESLIE WILKE | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Pulmonary Disease Physician (207RP1001X) |
United | A9558 | $263.77 | 1659371755 - DAVID HANDSHOE | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Pulmonary Disease Physician (207RP1001X) |
United | A9558 | $263.77 | 1548540578 - EMERALD ROSE BRANCH | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Internal Medicine Physician (207R00000X) |
United | A9558 | $227.11 | 1134122112 - MICHAEL SPANDORFER | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Pulmonary Disease Physician (207RP1001X) |
United | A9558 | $227.11 | 1508864968 - SOLA KIM | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | A9558 | $263.77 | 1508864968 - SOLA KIM | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | A9558 | $227.11 | 1639486160 - JARED INTAPHAN | 570978524 - (SC) LOWCOUNTRY LUNG CRITICAL CARE PA | SC | 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 A9558 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9558 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 A9558 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 |
|---|---|---|
| A9557-HCPCS | High | Technetium Tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries |
| A9558-HCPCS | Low | Xenon Xe-133 gas, diagnostic, per 10 millicuries |
| A9559-HCPCS | Low | Cobalt Co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9558 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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