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See a sample rate comparisonHCPCS G8561 Fee Schedule
HCPCS G8561 is classified under Procedures / Professional Services, in the Additional Quality Measures subgroup.
Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8561 by major payers:
$69.93
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G8561
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8561 vs. Other Additional Quality Measures Codes
The table lists codes related to G8561. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8560-HCPCS | Low | Patient has a history of active drainage from the ear within the previous 90 days |
| G8561-HCPCS | Low | Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure |
| G8562-HCPCS | Low | Patient does not have a history of active drainage from the ear within the previous 90 days |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8561 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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