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See a sample rate comparisonHCPCS G0101 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.
Cervical or vaginal cancer screening; pelvic and clinical breast examination
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Screening Examinations and Disease Management Training |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0101 |
National average reimbursement for HCPCS G0101 by major payers:
$49.31
$49.23
$46.59
$42.19
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HCPCS G0101
5 of 25 sample ratesHigher to lower in this preview
Annalese Williams
$93.58Published rateMichael Potruch
$62.56Published rateChristopher Raio
St Joseph Hospital
$56.57Published rateDenise Hew
Denise W. L. Hew, M.D., LLC
$46.72Published rateChristopher Raio
St Joseph Hospital
$38.13Published rate
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See a sample payer proposalHCPCS G0101 vs. Other Screening Examinations and Disease Management Training Codes
The HCPCS G0101 code is part of the Procedures / Professional Services services used for Screening Examinations and Disease Management Training. 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 G0101 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 |
|---|---|---|
| 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 |
| G0102-HCPCS | Low | Prostate cancer screening; digital rectal examination |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0101 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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