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See a sample rate comparisonHCPCS G0249 Fee Schedule
Medicare rates as of October 2026
HCPCS G0249 is classified under Procedures / Professional Services, in the Miscellaneous Diagnostic and Therapeutic Services subgroup.
Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $65.80 national non-facility rate (2026) · View Medicare rates for G0249 |
| Medicaid Fee Schedule | $54.645 median of the 8 states in the free preview · View Medicaid rates for G0249 |
National average reimbursement for HCPCS G0249 by major payers:
$84.37
BCBS / Anthem
$67.09
UnitedHealthcare
$78.37
Aetna
$74.82
Cigna
Compare published rates across providers.
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HCPCS G0249
5 of 25 sample ratesHigher to lower in this preview
Slidell Memorial Hospital, St Tammany Parish Hospital Service District #2
Slidell Memorial Hospital
$265.22Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$106.73Published rateLower Oconee Community Hospital Inc
$77.09Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$54.22Published rateKristina Jimenez
Miguel A Arenas Md PC
$23.68Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0249 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The table lists codes related to G0249. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0248-HCPCS | Low | Demonstration, prior to initiation of home INR monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the INR monitor, obtaining at least one blood sample, provision of instructions for reporting home INR test results, and documentation of patient's ability to perform testing and report results |
| G0249-HCPCS | Low | Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests |
| G0250-HCPCS | Low | Physician review, interpretation, and patient management of home INR testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0249. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0249 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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