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See a sample rate comparisonHCPCS G0406 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.
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Followup Telehealth Consultations |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0406 |
National average reimbursement for HCPCS G0406 by major payers:
$54.57
$49.83
$42.02
$43.59
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HCPCS G0406
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$100.30Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$65.45Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$43.15Published rateMain Line Pathology Associates, PC
Main Line Pathology Associates, P.C
$39.70Published rateAlicia Encinas
Miguel A Arenas Md PC
$31.89Published rate
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See a sample payer proposalHCPCS G0406 vs. Other Followup Telehealth Consultations Codes
The HCPCS G0406 code is part of the Procedures / Professional Services services used for Followup Telehealth Consultations. 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 G0406 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 |
|---|---|---|
| G0405-HCPCS | Low | Electrocardiogram, routine ECG with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination |
| G0406-HCPCS | Low | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth |
| G0407-HCPCS | Low | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0406 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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