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See a sample rate comparisonHCPCS G9395 Fee Schedule
HCPCS G9395 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Patient with an initial PHQ-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) PHQ-9 score greater than or equal to five
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9395 by major payers:
$68.61
BCBS / Anthem
$51.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9395
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See a sample payer proposalHCPCS G9395 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9395. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9394-HCPCS | Low | Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period |
| G9395-HCPCS | Low | Patient with an initial PHQ-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) PHQ-9 score greater than or equal to five |
| G9396-HCPCS | Low | Patient with an initial PHQ-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9395. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9395 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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