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See a sample rate comparisonHCPCS G9153 Fee Schedule
HCPCS G9153 is classified under Procedures / Professional Services, in the Primary Care Quality Measures subgroup.
MAPCP Demonstration - Physician Incentive Pool
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Primary Care Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9153 by major payers:
$71.24
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$7.99
Cigna
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HCPCS G9153
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9153 vs. Other Primary Care Quality Measures Codes
The table lists codes related to G9153. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9152-HCPCS | Low | MAPCP Demonstration - Community Health Teams |
| G9153-HCPCS | Low | MAPCP Demonstration - Physician Incentive Pool |
| G9156-HCPCS | Low | Evaluation for wheelchair requiring face to face visit with physician |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9153. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9153 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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