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See a sample rate comparisonHCPCS G9549 Fee Schedule
HCPCS G9549 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9549 by major payers:
$65.69
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9549
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See a sample payer proposalHCPCS G9549 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9549. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9548-HCPCS | Low | Final reports for imaging studies stating no follow-up imaging is recommended |
| G9549-HCPCS | Low | Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s)) |
| G9550-HCPCS | Low | Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9549. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9549 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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