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See a sample rate comparisonHCPCS G0534 Fee Schedule
HCPCS G0534 is classified under Procedures / Professional Services, in the Other Services subgroup.
Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose or treat an opioid use disorder; each additional 30 minutes of services (provision of the services by a medicare-enrolled opioid treatment program); (list separately in addition to each primary code)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0534 |
National average reimbursement for HCPCS G0534 by major payers:
$60.06
BCBS / Anthem
$52.71
UnitedHealthcare
$46.11
Aetna
$0.00
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0534.
HCPCS G0534
5 of 5 sample ratesHigher to lower in this preview
Aztec Urgent Care, LLC
Aztec Urgent Care LLC
$67.26Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$67.26Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$42.56Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$42.56Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$42.56Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0534 vs. Other Other Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0534-HCPCS | Low | Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose or treat an opioid use disorder; each additional 30 minutes of services (provision of the services by a medicare-enrolled opioid treatment program); (list separately in addition to each primary code) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0534. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0534 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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