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See a sample rate comparisonHCPCS G8635 Fee Schedule
HCPCS G8635 is classified under Procedures / Professional Services, in the Additional Quality Measures subgroup.
Pharmacologic therapy for osteoporosis was not prescribed, reason not given
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8635 by major payers:
$60.78
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G8635
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See a sample payer proposalHCPCS G8635 vs. Other Additional Quality Measures Codes
The table lists codes related to G8635. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8633-HCPCS | Low | Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed |
| G8635-HCPCS | Low | Pharmacologic therapy for osteoporosis was not prescribed, reason not given |
| G8647-HCPCS | Low | Residual score for the knee impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8635 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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