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See a sample rate comparisonHCPCS G8970 Fee Schedule
HCPCS G8970 is classified under Procedures / Professional Services, in the More Quality Measures subgroup.
No risk factors or one moderate risk factor for thromboembolism
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services More Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8970 by major payers:
$59.97
BCBS / Anthem
$54.00
UnitedHealthcare
$0.03
Aetna
$1.35
Cigna
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HCPCS G8970
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8970 vs. Other More Quality Measures Codes
The table lists codes related to G8970. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8969-HCPCS | Low | Documentation of patient reason(s) for not prescribing an oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient preference for not receiving anticoagulation) |
| G8970-HCPCS | Low | No risk factors or one moderate risk factor for thromboembolism |
| G9001-HCPCS | Low | Coordinated care fee, initial rate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8970 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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