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See a sample rate comparisonHCPCS G9152 Fee Schedule
HCPCS G9152 is classified under Procedures / Professional Services, in the Primary Care Quality Measures subgroup.
MAPCP Demonstration - Community Health Teams
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Primary Care Quality Measures |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G9152 |
National average reimbursement for HCPCS G9152 by major payers:
$71.24
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$0.00
Cigna
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HCPCS G9152
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9152 vs. Other Primary Care Quality Measures Codes
The table lists codes related to G9152. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9151-HCPCS | Low | MAPCP Demonstration - state provided services |
| G9152-HCPCS | Low | MAPCP Demonstration - Community Health Teams |
| G9153-HCPCS | Low | MAPCP Demonstration - Physician Incentive Pool |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9152. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9152 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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