PayerPrice
Data Platform
Who We Serve
Use Cases
More
Check Local Rates

HCPCS G0549 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.

Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patient's treating/requesting practitioner; 31 or more minutes of medical consultative discussion and review
Key FactDetail
Service Type

Procedures / Professional Services

Other Services

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for G0549

National average reimbursement for HCPCS G0549 by major payers:

bcbs

$103.70

uhc

$69.75

aetna

$64.80

cigna

$71.84

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS G0549.

HCPCS G0549
5 of 25 sample ratesHigher to lower in this preview
  1. Emory Crawford Long Hospital

    Emory University

    GAGeneral Acute Care HospitalNPI 1225281603Tax ID 58-2030692

    $183.25Published rate
  2. Brooks County Hospital

    GACritical Access HospitalNPI 1306890942Tax ID 58-6002830

    $135.57Published rate
  3. The Hospital Authority Of Miller County, Miller County Hospital - Pro Fees

    The Hospital Authority Of Miller County

    GACritical Access HospitalNPI 1710105119Tax ID 58-6010601

    $101.70Published rate
  4. Victoria Lewis-Holland

    GAGeneral Acute Care HospitalNPI 1487721718Tax ID 58-6011888

    $93.91Published rate
  5. Hospital Authority Of Washington County, Washington County Regional Medical Center

    Hospital Authority Of Washington County

    GARural Acute Care HospitalNPI 1396770004Tax ID 58-6012329

    $77.98Published rate

National sample. Rates vary by location, specialty, and contract.

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.

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 comparison

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 proposal

HCPCS G0549 vs. Other Other Services Codes

The HCPCS G0549 code is part of the Procedures / Professional Services services used for Other 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 G0549 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.

CodeComplexityDescription
G0549-HCPCSLowInterprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patient's treating/requesting practitioner; 31 or more minutes of medical consultative discussion and review

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0549. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G0549 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 G0549) and we'll show you how you compare in 15 minutes or less.