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See a sample rate comparisonHCPCS M0201 Fee Schedule
Last Verified: October 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.
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home
| Key Fact | Detail |
|---|---|
| Service Type | Miscellaneous Medical Services |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for M0201 |
National average reimbursement for HCPCS M0201 by major payers:
$45.68
$42.45
$43.57
$40.62
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HCPCS M0201
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$113.33Published rateChu Chen
$76.75Published rateHospital Authority Of Ben Hill, Dorminy Medical Center
$51.00Published rateChristopher Raio
St Francis Hospital
$42.55Published rateCindy Chang
Miguel A Arenas Md PC
$30.85Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS M0201 vs. Other Miscellaneous Medical Services Codes
The HCPCS M0201 code is part of the Miscellaneous Medical Services 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 M0201 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 |
|---|---|---|
| M0100-HCPCS | Low | Intragastric hypothermia using gastric freezing |
| M0201-HCPCS | Low | Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS M0201. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the M0201 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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