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See a sample rate comparisonHCPCS G8539 Fee Schedule
HCPCS G8539 is classified under Procedures / Professional Services, in the Additional Quality Measures subgroup.
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8539 by major payers:
$56.65
BCBS / Anthem
$39.30
UnitedHealthcare
$0.03
Aetna
$1.16
Cigna
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HCPCS G8539
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8539 vs. Other Additional Quality Measures Codes
The table lists codes related to G8539. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8536-HCPCS | Low | No documentation of an elder maltreatment screen, reason not given |
| G8539-HCPCS | Low | Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
| G8540-HCPCS | Low | Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8539 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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