HCPCS K1034 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Components, Accessories and Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS K1034 by major payers:
$10.93
$8.33
$12.08
$8.02
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS K1034 | ||||||
United | K1034 | $7.80 | 1861478851 - CLINCH COUNTY HOSPITAL AUTHORITY | 586011853 - (GA) CLINCH COUNTY HOSPITAL AUTHORITY | GA | Critical Access Hospital (282NC0060X) |
United | K1034 | $7.19 | 1881144889 - NGMC BARROW LLC, NGMC BARROW | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $7.19 | 1730110826 - EVANS MEMORIAL HOSPITAL, INC. | 582257925 - (GA) EVANS MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $7.19 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $7.19 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | K1034 | $7.19 | 1740272095 - DODGE COUNTY HOSPITAL AUTHORITY, DODGE COUNTY HOSPITAL | 580625140 - (GA) DODGE COUNTY HOSPITAL AUTHORITY | GA | Rural Acute Care Hospital (282NR1301X) |
United | K1034 | $7.19 | 1245201094 - SCREVEN COUNTY HOSPITAL | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | K1034 | $7.19 | 1427055821 - NORTHEAST GEORGIA MEDICAL CENTER, INC. | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $7.19 | 1790942381 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM MEDICAL CENTER - TATTNALL | 300466706 | GA | Critical Access Hospital (282NC0060X) |
United | K1034 | $25.20 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | K1034 | $7.34 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | K1034 | $9.60 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $7.49 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Multi-Specialty Group (193200000X) |
United | K1034 | $12.00 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
United | K1034 | $10.80 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS K1034 vs. Other Components, Accessories and Supplies Codes
The HCPCS K1034 code is part of the Components, Accessories and Supplies services . 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 K1034 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 |
|---|---|---|
| K1033-HCPCS | Low | Non-pneumatic sequential compression garment, half leg |
| K1034-HCPCS | Low | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
| K1035-HCPCS | Low | Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K1034. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K1034 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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