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See a sample rate comparisonHealthcare 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 A9698 by major payers:

$337.38

$46.91

$124.71

$28.14
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalHCPCS A9698 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9698 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 A9698 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 |
|---|---|---|
| A9607-HCPCS | Moderate | Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie |
| A9698-HCPCS | Moderate | Non-radioactive contrast imaging material, not otherwise classified, per study |
| A9699-HCPCS | High | Radiopharmaceutical, therapeutic, not otherwise classified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9698. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9698 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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