HCPCS B9004 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 | Enteral and Parenteral Therapy Nutrition Infusion Pumps and Supplies Not Otherwise Classified, NOC |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for B9004 |
National average reimbursement for HCPCS B9004 by major payers:
$2,306.71
$3,007.83
$470.58
$4,300.70
HCPCS B9004 vs. Other Nutrition Infusion Pumps and Supplies Not Otherwise Classified, NOC Codes
The HCPCS B9004 code is part of the Enteral and Parenteral Therapy services used for Nutrition Infusion Pumps and Supplies Not Otherwise Classified, NOC. 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 B9004 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 |
|---|---|---|
| B9002-HCPCS | Moderate | Enteral nutrition infusion pump, any type |
| B9004-HCPCS | High | Parenteral nutrition infusion pump, portable |
| B9006-HCPCS | High | Parenteral nutrition infusion pump, stationary |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B9004. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B9004 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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