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See a sample rate comparisonHCPCS G9946 Fee Schedule
HCPCS G9946 is classified under Procedures / Professional Services, in the Pain assessment subgroup.
Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Pain assessment |
| Complexity Level | Low |
National average reimbursement for HCPCS G9946 by major payers:
$69.91
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9946
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9946 vs. Other Pain assessment Codes
The table lists codes related to G9946. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9945-HCPCS | Low | Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis |
| G9946-HCPCS | Low | Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively |
| G9949-HCPCS | Low | Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9946 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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