HCPCS B4164 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 | • Enteral and Parenteral Therapy • Parenteral Solutions and Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS B4164 by major payers:
$19.90
$20.43
$19.58
$25.50
| 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 B4164 | ||||||
United | B4164 | $8.19 | 1235153883 - WILDWOOD SANITARIUM, INCORPORATED, WILDWOOD LIFESTYLE CENTER AND HOSPITAL | 586039864 - (GA) WILDWOOD SANITARIUM INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | B4164 | $34.52 | 1427189927 - DEVON DANEY | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Family Medicine Physician (207Q00000X) |
United | B4164 | $26.87 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | B4164 | $66.22 | 1689744450 - ARTHUR M. BLANK HOSPITAL, INC., ARTHUR M. BLANK HOSPITAL | 582147112 - (GA) CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | B4164 | $66.22 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | B4164 | $20.50 | 1740272095 - DODGE COUNTY HOSPITAL AUTHORITY, DODGE COUNTY HOSPITAL | 580625140 - (GA) DODGE COUNTY HOSPITAL AUTHORITY | GA | Rural Acute Care Hospital (282NR1301X) |
United | B4164 | $43.05 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | B4164 | $12.30 | 1013553197 - AMY MOORE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Acute Care Nurse Practitioner (363LA2100X) |
United | B4164 | $26.87 | 1568410264 - TIFT REGIONAL HEALTH SYSTEM, INC., SOUTHWELL MEDICAL | 453072990 - (GA) TIFT REGIONAL HEALTH SYSTEM INC | GA | General Acute Care Hospital (282N00000X) |
United | B4164 | $87.05 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | B4164 | $41.63 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | B4164 | $18.45 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | B4164 | $7.38 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | B4164 | $12.30 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | B4164 | $20.50 | 1427055821 - NORTHEAST GEORGIA MEDICAL CENTER, INC. | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
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 B4164 vs. Other Parenteral Solutions and Supplies Codes
The HCPCS B4164 code is part of the Enteral and Parenteral Therapy services used for Parenteral Solutions and Supplies. 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 B4164 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 |
|---|---|---|
| B4162-HCPCS | Low | Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
| B4164-HCPCS | Low | Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - homemix |
| B4168-HCPCS | Low | Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - homemix |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B4164. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4164 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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