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See a sample rate comparisonHCPCS G9869 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G9869 |
National average reimbursement for HCPCS G9869 by major payers:
$49.48
$48.87
$37.16
$38.60
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HCPCS G9869
5 of 25 sample ratesHigher to lower in this preview
Kamran Rajaee
$114.87Published rateCabrini Sutherland
Surgical Specialists Of Charlotte, PA
$70.15Published rateJulie Webster
Carolina Radiology Associates, LLC
$52.72Published rateJulie Webster
Musc Community Physicians
$42.47Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
Hospital Authority Of Washington County
$38.40Published rate
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See a sample payer proposalHCPCS G9869 vs. Other Additional Assorted Quality Measures Codes
The HCPCS G9869 code is part of the Procedures / Professional Services services used for Additional Assorted Quality Measures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G9869 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| G9868-HCPCS | Low | Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes |
| G9869-HCPCS | Low | Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes |
| G9870-HCPCS | Low | Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9869. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9869 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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