HCPCS G0399 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Sleep Studies, In Home |
| Complexity Level | Low |
National average reimbursement for HCPCS G0399 by major payers:
$155.30
$226.40
$180.72
$144.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G0399 | ||||||
United | G0399 | $167.75 | 1104814243 - STEVEN KELSEN | 231365971 - TEMPLE UNIVERSITY-OF THE COMMONWEALTH SYSTEM OF HIGHER EDUC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $161.67 | 1093703043 - SAMUEL KRACHMAN | 232790607 - (PA) TEMPLE PHYSICIANS INC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $161.67 | 1003259987 - EDUARDO DOMINGUEZ CASTILLO | 831002191 - TEMPLE FACULTY PRACTICE PLAN INC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $66.83 | 1083677868 - SUSQUEHANNA PHYSICIAN SERVICES, SUSQUEHANNA HEALTH MEDICAL GROUP | 232449454 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $439.79 | 1538115282 - THOMAS RICE | 232919472 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $112.55 | 1457738700 - BRIAN CHWIECKO | 231352204 - (PA) READING HOSPITAL | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $162.96 | 1891760740 - PATRICK STROLLO | 251727721 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $149.92 | 1396765384 - PAUL STELMACH | 232380812 - ST LUKES PHYSICIAN GROUP INC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $170.52 | 1770937351 - KRISTEN RAFFENSPERGER | 232919472 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $96.34 | 1881836930 - RAMANI GOSALA | 223837316 - WARREN HEALTH CARE ALLIANCE, PC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $41.25 | 1841634466 - JOSEPH RAMZY | 223837316 - WARREN HEALTH CARE ALLIANCE, PC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $269.26 | 1801856125 - ANDREW PEREZ | 232919472 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $361.48 | 1962415182 - RAMI KHAYAT | 954482087 | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $264.48 | 1366758518 - SUNEET PAHWA | 461177336 - ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC | PA | Pulmonary Disease Physician (207RP1001X) |
United | G0399 | $207.97 | 1225325095 - RAHUL MEHTA | 232380812 - ST LUKES PHYSICIAN GROUP INC | PA | Pulmonary Disease Physician (207RP1001X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS G0399 vs. Other Sleep Studies, In Home Codes
The HCPCS G0399 code is part of the Procedures / Professional Services services used for Sleep Studies, In Home. 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 G0399 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 |
|---|---|---|
| G0398-HCPCS | Low | Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation |
| G0399-HCPCS | Low | Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
| G0400-HCPCS | Low | Home sleep test (HST) with type IV portable monitor, unattended; minimum of 3 channels |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0399. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0399 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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