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See a sample rate comparisonHCPCS G9456 Fee Schedule
HCPCS G9456 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Documentation of medical or patient reason(s) for not ordering or performing screening for HCC. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9456 by major payers:
$71.06
BCBS / Anthem
$51.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9456
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See a sample payer proposalHCPCS G9456 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9456. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9455-HCPCS | Low | Patient underwent abdominal imaging with ultrasound, contrast enhanced CT or contrast MRI for HCC |
| G9456-HCPCS | Low | Documentation of medical or patient reason(s) for not ordering or performing screening for HCC. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment) |
| G9457-HCPCS | Low | Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9456. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9456 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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