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See a sample rate comparisonHCPCS M1016 Fee Schedule
HCPCS M1016 is classified under Screening Procedures, in the Patient Status subgroup.
Female patients unable to bear children
| Key Fact | Detail |
|---|---|
| Service Type | Screening Procedures Patient Status |
| Complexity Level | Low |
National average reimbursement for HCPCS M1016 by major payers:
$70.12
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
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HCPCS M1016
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Payer Contract Negotiation
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See a sample payer proposalHCPCS M1016 vs. Other Patient Status Codes
The table lists codes related to M1016. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| M1014-HCPCS | Low | Discharge/discontinuation of the episode of care documented in the medical record |
| M1016-HCPCS | Low | Female patients unable to bear children |
| M1018-HCPCS | Low | Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS M1016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the M1016 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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