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See a sample rate comparisonHCPCS G9314 Fee Schedule
HCPCS G9314 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9314 by major payers:
$69.94
BCBS / Anthem
$54.00
UnitedHealthcare
$0.03
Aetna
$1.16
Cigna
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HCPCS G9314
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9314 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9314. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9313-HCPCS | Low | Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason |
| G9314-HCPCS | Low | Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given |
| G9315-HCPCS | Low | Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9314. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9314 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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