Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS G0540 Fee Schedule
Medicare rates as of October 2026
HCPCS G0540 is classified under Procedures / Professional Services, in the Other Services subgroup.
Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $26.05 national non-facility rate (2026) · View Medicare rates for G0540 |
| Medicaid Fee Schedule | $22.895 median of the 4 states in the free preview · View Medicaid rates for G0540 |
National average reimbursement for HCPCS G0540 by major payers:
$57.86
BCBS / Anthem
$30.78
UnitedHealthcare
$22.23
Aetna
$115.27
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0540.
HCPCS G0540
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$90.26Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$49.09Published rateSmith Of Georgia, Smith Northview Hospitalists
Smith Of Georgia
$41.65Published rateHospital Authority Of Jenkins County
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$34.65Published rateNgmc Barrow LLC, Ngmc Barrow
Gainesville Radiology Group
$28.51Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS G0540 vs. Other Other Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0540-HCPCS | Low | Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0540 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS G0540) and we'll show you how you compare in 15 minutes or less.