HCPCS G0090 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 | • Procedures / Professional Services • Initial Visit for Professional Services |
| Complexity Level | Moderate |
National average reimbursement for HCPCS G0090 by major payers:
$484.97
$455.72
$312.43
$378.33
| 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 G0090 | ||||||
United | G0090 | $486.51 | 1982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | G0090 | $837.67 | 1306890942 - BROOKS COUNTY HOSPITAL | 586002830 | GA | Critical Access Hospital (282NC0060X) |
United | G0090 | $432.26 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
United | G0090 | $293.76 | 1548859895 - ALICIA ENCINAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | CA | Family Nurse Practitioner (363LF0000X) |
United | G0090 | $628.05 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | G0090 | $400.30 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | G0090 | $345.85 | 1033165865 - DAVID EPSTEIN | 462439952 - (FL) BREVARD PHYSICIAN ASSOCIATES, PLLC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | G0090 | $525.70 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | G0090 | $283.64 | 1316561236 - CINDY CHANG | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | G0090 | $957.90 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | G0090 | $914.36 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | G0090 | $540.72 | 1508361841 - CHRISTOPHER CHAMBERS | 10594994 - COOPERATIVE HEALTHCARE SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | G0090 | $1178.50 | 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 | G0090 | $1239.40 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | G0090 | $437.57 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
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 G0090 vs. Other Initial Visit for Professional Services Codes
The HCPCS G0090 code is part of the Procedures / Professional Services services used for Initial Visit for Professional 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 G0090 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 |
|---|---|---|
| G0089-HCPCS | Moderate | Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes |
| G0090-HCPCS | Moderate | Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes |
| G0101-HCPCS | Low | Cervical or vaginal cancer screening; pelvic and clinical breast examination |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0090. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0090 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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