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See a sample rate comparisonHCPCS G9765 Fee Schedule
HCPCS G9765 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9765 by major payers:
$72.32
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9765
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9765 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9765. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9764-HCPCS | Low | Patient has been treated with a systemic medication for psoriasis vulgaris |
| G9765-HCPCS | Low | Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi |
| G9766-HCPCS | Low | Patients who are transferred from one institUTIon to another with a known diagnosis of CVA for endovascular stroke treatment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9765. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9765 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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