HCPCS A9561 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 |
| Common Place of Service | |
| Common Modifiers | |
| Complexity Level | Moderate |
National average reimbursement for HCPCS A9561 by major payers:
$65.08
$51.03
$46.74
$54.36
| 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 A9561 | ||||||
United | A9561 | $50.15 | 1497760839 - LORISSA WALZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | A9561 | $50.15 | 1295983179 - CYRILLO ARAUJO | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | A9561 | $50.15 | 1932100906 - ROBERT KEENAN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X) |
United | A9561 | $50.15 | 1427440544 - STEPHANIE BONVENTRE | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | A9561 | $50.15 | 1932730439 - RACHEL MARRA | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | A9561 | $50.15 | 1417944638 - JAMEEL ARASTU | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Neurology Physician (2084N0400X) |
United | A9561 | $50.15 | 1669640348 - KENNETH GAGE | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | A9561 | $50.15 | 1629699350 - AMY JAYSON | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | A9561 | $50.15 | 1750887709 - MATTHEW MILLS | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Radiation Oncology Physician (2085R0001X) |
United | A9561 | $50.15 | 1629738422 - KASSANDRA GIGLIO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | A9561 | $50.15 | 1437291689 - MOHSIN SYED | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Internal Medicine Physician (207R00000X) |
United | A9561 | $50.15 | 1265669410 - KRISTEN OTTO | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Otolaryngology Physician (207Y00000X) |
United | A9561 | $50.15 | 1043201411 - TRACEY O'CONNOR | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Medical Oncology Physician (207RX0202X) |
United | A9561 | $50.15 | 1043782444 - ERICA CHU | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | A9561 | $50.15 | 1083078604 - MARILIN NICHOLSON | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Urology Physician (208800000X) |
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 A9561 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9561 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 A9561 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 |
|---|---|---|
| A9560 | Low | Technetium Tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries |
| A9561 | Low | Technetium Tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries |
| A9562 | Moderate | Technetium Tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9561 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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