HCPCS M0201 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 | • Miscellaneous Medical Services |
| Complexity Level | Low |
National average reimbursement for HCPCS M0201 by major payers:
$45.68
$42.45
$43.57
$40.62
| 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 M0201 | ||||||
United | M0201 | $84.37 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | M0201 | $51.00 | 1073567038 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | M0201 | $40.26 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | M0201 | $45.40 | 1225031750 - JASPER HEALTH SERVICES, INC., JASPER MEMORIAL HOSPITAL | 582510435 - (GA) JASPER HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | M0201 | $62.84 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | M0201 | $47.84 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | M0201 | $37.86 | 1306136551 - UJUKA ILOABUCHI | 582422542 - ATLANTA WOMENS HEALTH GROUP, P.C. | GA | Women's Hospital (282NW0100X) |
United | M0201 | $45.54 | 1992720791 - OMEGA HOSPITAL LLC | 470901008 - (LA) OMEGA HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | M0201 | $86.84 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | M0201 | $68.08 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | M0201 | $51.00 | 1245248624 - HOSPITAL AUTHORITY OF BEN HILL, DORMINY MEDICAL CENTER | 581157005 | GA | Rural Acute Care Hospital (282NR1301X) |
United | M0201 | $30.85 | 1316561236 - CINDY CHANG | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | M0201 | $90.97 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | M0201 | $36.45 | 1548859895 - ALICIA ENCINAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | CA | Family Nurse Practitioner (363LF0000X) |
United | M0201 | $90.97 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
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 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 | Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home |
| M0220-HCPCS | Low | Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
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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