Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS H1011 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.
Family assessment by licensed behavioral health professional for state defined purposes
| Key Fact | Detail |
|---|---|
| Service Type | Alcohol and Drug Abuse Treatment Prenatal Care and Family Planning Assessment |
| Common Place of Service | 11 - Office 10 - Telehealth in Patient's Home 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for H1011 |
National average reimbursement for HCPCS H1011 by major payers:
$65.08
$54.46
$90.12
$23.68
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS H1011.
HCPCS H1011
5 of 10 sample ratesHigher to lower in this preview
Crosbyton Clinic Hospital
$1,272.00Published rateRehabcare Group East, LLC, Rehabcare
$60.00Published rateRehabcare Group East, LLC, Rehabcare
$55.00Published rateRehabcare Group East, LLC, Rehabcare
$40.00Published rateRehabcare Group East, LLC, Rehabcare
$35.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS H1011 vs. Other Prenatal Care and Family Planning Assessment Codes
The HCPCS H1011 code is part of the Alcohol and Drug Abuse Treatment services used for Prenatal Care and Family Planning Assessment. 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 H1011 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 |
|---|---|---|
| H1010-HCPCS | Low | Non-medical family planning education, per session |
| H1011-HCPCS | Low | Family assessment by licensed behavioral health professional for state defined purposes |
| H2000-HCPCS | Low | Comprehensive multidisciplinary evaluation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS H1011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the H1011 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS H1011) and we'll show you how you compare in 15 minutes or less.