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See a sample rate comparisonHCPCS G0013 Fee Schedule
Medicare rates as of October 2026
HCPCS G0013 is classified under Procedures / Professional Services, in the Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services subgroup.
Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $24.38 national non-facility rate (2026) · View Medicare rates for G0013 |
| Medicaid Fee Schedule | $19.62 median of the 8 states in the free preview · View Medicaid rates for G0013 |
National average reimbursement for HCPCS G0013 by major payers:
$30.32
BCBS / Anthem
$20.37
UnitedHealthcare
$24.89
Aetna
$38.12
Cigna
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HCPCS G0013
5 of 25 sample ratesHigher to lower in this preview
Matthew Lilley
Bend Memorial Clinic, PC
$71.11Published rateUjuka Iloabuchi
$43.83Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$33.95Published rateThe Hospital Authority Of Habersham County
$30.60Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$27.23Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0013 vs. Other Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0013-HCPCS | Low | Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0013 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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