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See a sample rate comparisonHCPCS G0469 Fee Schedule
HCPCS G0469 is classified under Procedures / Professional Services, in the Federally Qualified Health Center (FQHC) Visits subgroup.
Federally qualified health center (FQHC) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Federally Qualified Health Center (FQHC) Visits |
| Medicaid Fee Schedule | View Medicaid rates for G0469 |
National average reimbursement for HCPCS G0469 by major payers:
$139.75
BCBS / Anthem
$191.63
UnitedHealthcare
$137.75
Aetna
$44.63
Cigna
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HCPCS G0469
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See a sample payer proposalHCPCS G0469 vs. Other Federally Qualified Health Center (FQHC) Visits Codes
The table lists codes related to G0469. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0468-HCPCS | Federally qualified health center (FQHC) visit, ippe or awv; a FQHC visit that includes an initial preventive physical examination (IPPE) or annual wellness visit (AWV) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an IPPE or AWV |
| G0469-HCPCS | Federally qualified health center (FQHC) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
| G0470-HCPCS | Federally qualified health center (FQHC) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0469. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0469 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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