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See a sample rate comparisonHCPCS G9054 Fee Schedule
HCPCS G9054 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a Medicare-approved demonstration project)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Medicare Demonstration Projects |
| Complexity Level | Low |
National average reimbursement for HCPCS G9054 by major payers:
$59.89
BCBS / Anthem
$9.63
UnitedHealthcare
$0.25
Aetna
$7.22
Cigna
Compare published rates across providers.
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HCPCS G9054
5 of 25 sample ratesHigher to lower in this preview
Hospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$19.20Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$16.11Published rateKristina Jimenez
Miguel A Arenas Md PC
$10.19Published rateJulie Webster
Musc Community Physicians
$8.43Published rateCindy Chang
Miguel A Arenas Md PC
$5.98Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9054 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9054. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9053-HCPCS | Low | Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a Medicare-approved demonstration project) |
| G9054-HCPCS | Low | Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a Medicare-approved demonstration project) |
| G9055-HCPCS | Low | Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a Medicare-approved demonstration project) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9054. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9054 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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