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See a sample rate comparisonHCPCS G9213 Fee Schedule
HCPCS G9213 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
DSM-IV-TR criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9213 by major payers:
$61.39
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9213
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9213 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9213. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9212-HCPCS | Low | DSM-IVTM criteria for major depressive disorder documented at the initial evaluation |
| G9213-HCPCS | Low | DSM-IV-TR criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified |
| G9223-HCPCS | Low | Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low CD4+ cell count below 500 cells/mm3 or a CD4 percentage below 15% |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9213. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9213 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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