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See a sample rate comparisonHCPCS G0498 Fee Schedule
HCPCS G0498 is classified under Procedures / Professional Services, in the Other Services subgroup.
Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Hospital Outpatient Group (APC) | APC 5694 - Level 4 Drug Administration |
| Common Revenue Codes | 03350280 |
| Medicaid Fee Schedule | $163.645 median of the 6 states in the free previewView Medicaid rates for G0498 |
National average reimbursement for HCPCS G0498 by major payers:
$289.08
BCBS / Anthem
$267.98
UnitedHealthcare
$199.70
Aetna
$239.49
Cigna
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HCPCS G0498
5 of 25 sample ratesHigher to lower in this preview
Donald Brooks
$565.63Published rateMichael Lyster
$388.39Published rateRobert Yoo
$312.61Published rateSyed Akbar
$256.39Published rateAwais Khan
$141.97Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0498 vs. Other Other Services Codes
The table lists codes related to G0498. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0496-HCPCS | Skilled services of a licensed practical nurse (LPN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes |
| G0498-HCPCS | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion |
| G0499-HCPCS | Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0498. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0498 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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Frequently Asked Questions
What APC is HCPCS G0498 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0498 to APC 5694 (Level 4 Drug Administration). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0498?
Hospital price transparency files list HCPCS G0498 under these revenue codes: 0335 and 0280. A revenue code names the hospital department or charge category for the line; it does not change what the service is.