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See a sample rate comparisonHCPCS G0250 Fee Schedule
Medicare rates as of October 2026
HCPCS G0250 is classified under Procedures / Professional Services, in the Miscellaneous Diagnostic and Therapeutic Services subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $9.02 national non-facility rate (2026) · View Medicare rates for G0250 |
| Medicaid Fee Schedule | $7.675 median of the 8 states in the free preview · View Medicaid rates for G0250 |
National average reimbursement for HCPCS G0250 by major payers:
$12.28
BCBS / Anthem
$11.82
UnitedHealthcare
$10.07
Aetna
$9.29
Cigna
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HCPCS G0250
5 of 25 sample ratesHigher to lower in this preview
Kamran Rajaee
$27.89Published ratePhoebe Worth Medical Center, Inc, Phoebe Worth Medical Center, Inc
Phoebe Worth Medical Center Inc
$16.92Published rateElbert Memorial Hospital
$12.67Published rateDonalsonville Hospital Inc
$10.89Published rateMichael Koch
Pathology Lab Of Georgia LLC
$9.38Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0250 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The table lists codes related to G0250. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| G0252-HCPCS | Moderate | PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0250 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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