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See a sample rate comparisonHCPCS G0103 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.
Prostate cancer screening; prostate specific antigen test (PSA)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Screening Examinations and Disease Management Training |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0103 |
National average reimbursement for HCPCS G0103 by major payers:
$18.20
$13.52
$25.09
$17.39
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HCPCS G0103
5 of 25 sample ratesHigher to lower in this preview
Eduard Fuzaylov
New York Gracie Square Hospital Inc
$29.27Published rateLiviu Rappaport
Primary Care Partners, LLC
$27.32Published rateRobert Denniston
$9.60Published rateShaileja Pamnani
Heart Vascular Associates Of Northern Jersey PA
$8.80Published rateBrian Weiss
Warren Health Care Alliance, PC
$8.10Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0103 vs. Other Screening Examinations and Disease Management Training Codes
The HCPCS G0103 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 G0103 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 |
|---|---|---|
| G0102-HCPCS | Low | Prostate cancer screening; digital rectal examination |
| G0103-HCPCS | Low | Prostate cancer screening; prostate specific antigen test (PSA) |
| G0104-HCPCS | Low | Colorectal cancer screening; flexible sigmoidoscopy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0103. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0103 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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