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See a sample rate comparisonHCPCS G0013 Fee Schedule
Last Verified: September 2026
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.
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 |
| Medicaid Fee Schedule | View Medicaid rates for G0013 |
National average reimbursement for HCPCS G0013 by major payers:
$30.32
$20.37
$24.89
$38.12
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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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See a sample payer proposalHCPCS G0013 vs. Other Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services Codes
The HCPCS G0013 code is part of the Procedures / Professional Services services used for Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services. 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 G0013 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 |
|---|---|---|
| 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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