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See a sample rate comparisonHCPCS G0137 Fee Schedule
HCPCS G0137 is classified under Procedures / Professional Services, in the Miscellaneous Diagnostic and Therapeutic Services subgroup.
Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $724.305 median of the 2 states in the free preview · View Medicaid rates for G0137 |
National average reimbursement for HCPCS G0137 by major payers:
$535.91
BCBS / Anthem
$1,017.03
UnitedHealthcare
$788.54
Aetna
$1,047.56
Cigna
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HCPCS G0137
5 of 5 sample ratesHigher to lower in this preview
Aztec Urgent Care, LLC
Aztec Urgent Care LLC
$1,297.96Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$1,297.96Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$821.50Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$821.50Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$821.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0137 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0137-HCPCS | Moderate | Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0137. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0137 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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