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See a sample rate comparisonHCPCS G9511 Fee Schedule
HCPCS G9511 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
National average reimbursement for HCPCS G9511 by major payers:
$59.19
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9511
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See a sample payer proposalHCPCS G9511 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9511. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G9510-HCPCS | Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5 |
| G9511-HCPCS | Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period |
| G9512-HCPCS | Individual had a PDC of 0.8 or greater |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9511 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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