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HCPCS G0420 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.

Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
Key FactDetail
Service Type

Procedures / Professional Services

Face-to-Face Educational Services

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for G0420

National average reimbursement for HCPCS G0420 by major payers:

bcbs

$140.44

uhc

$142.96

aetna

$115.72

cigna

$116.29

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS G0420.

HCPCS G0420
5 of 25 sample ratesHigher to lower in this preview
  1. Emory University, Emory University Hospital

    Emory University

    GAGeneral Acute Care HospitalNPI 1588640692Tax ID 58-0566256

    $371.50Published rate
  2. Brooks County Hospital

    GACritical Access HospitalNPI 1306890942Tax ID 58-6002830

    $239.16Published rate
  3. Ty Cobb Healthcare System, Cobb Memorial Hospital

    Community Services Group Inc

    GARural Acute Care HospitalNPI 1083711691Tax ID 58-0633978

    $188.72Published rate
  4. Augusta Vamc

    GAGeneral Acute Care HospitalNPI 1801844469Tax ID 58-2089405

    $144.96Published rate
  5. Michael Koch

    Chestatee Pathology Associates PC

    GAGeneral Acute Care HospitalNPI 1508900101Tax ID 30-450086

    $114.31Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS G0420 vs. Other Face-to-Face Educational Services Codes

The HCPCS G0420 code is part of the Procedures / Professional Services services used for Face-to-Face Educational Services. 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 G0420 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.

CodeComplexityDescription
G0416-HCPCSModerateSurgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
G0420-HCPCSLowFace-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
G0421-HCPCSLowFace-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G0420 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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