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See a sample rate comparisonHCPCS G0459 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.
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Services |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0459 |
National average reimbursement for HCPCS G0459 by major payers:
$59.46
$55.81
$41.61
$45.20
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HCPCS G0459
5 of 25 sample ratesHigher to lower in this preview
David Epstein
Brevard Physician Associates, PLLC
$115.54Published rateMichael Guillette
Aztec Urgent Care LLC
$79.98Published rateChristopher Raio
St Joseph Hospital
$57.92Published rateHospital Authority Of Liberty County, Liberty Regional Medical Center
$45.83Published rateCindy Chang
Miguel A Arenas Md PC
$32.20Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0459 vs. Other Miscellaneous Services Codes
The HCPCS G0459 code is part of the Procedures / Professional Services services used for Miscellaneous 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 G0459 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 |
|---|---|---|
| G0458-HCPCS | Moderate | Low dose rate (LDR) prostate brachytherapy services, composite rate |
| G0459-HCPCS | Low | Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy |
| G0460-HCPCS | Moderate | Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0459. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0459 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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