HCPCS P9052 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 | • Pathology and Laboratory Services • Blood and Blood Products, with Associated Procedures |
| Complexity Level | Moderate |
National average reimbursement for HCPCS P9052 by major payers:
$875.03
$841.71
$695.96
$415.93
| 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 P9052 | ||||||
United | P9052 | $824.73 | 1568663920 - PROGRESSIVE ACUTE CARE AVOYELLES, LLC, AVOYELLES HOSPITAL | 813465468 | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $621.98 | 1568461572 - WILLIS KNIGHTON MEDICAL CENTER, INC. | 720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $871.92 | 1205833241 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER | 813465517 | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $2286.81 | 1598798597 - ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1, ST. TAMMANY PARISH HOSPITAL | 720478620 | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $941.67 | 1992720791 - OMEGA HOSPITAL LLC | 470901008 - (LA) OMEGA HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $932.96 | 1043392491 - DOCTORS' HOSPITAL OF SLIDELL, LLC, STERLING SURGICAL HOSPITAL | 522363244 - (LA) DOCTORS HOSPITAL OF SLIDELL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $1517.52 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $824.73 | 1104873710 - CLHG-OAKDALE, LLC, OAKDALE COMMUNITY HOSPITAL | 813465783 - (LA) CLHGOAKDALE LLC | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $621.98 | 1124170691 - WILLIS KNIGHTON MEDICAL CENTER, INC., WILLIS KNIGHTON SOUTH HOSPITAL | 720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $1209.63 | 1821465576 - LAKE SURGICAL HOSPITAL SLIDELL, LLC, SOUTHERN SURGICAL HOSPITAL | 474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $1177.10 | 1083661409 - LALLIE KEMP MEDICAL CTR, LALLIE KEMP REGIONAL MEDICAL CENTER | 726000749 | LA | Critical Access Hospital (282NC0060X) |
United | P9052 | $915.53 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $1358.90 | 1619061769 - ANNA JAQUES HOSPITAL | 42104338 - (MA) ANNA JAQUES HOSPITAL | MA | Psychiatric Hospital Unit (273R00000X) |
United | P9052 | $621.98 | 1902465065 - THIBODAUX REGIONAL HEALTH SYSTEM INC | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | General Acute Care Hospital (282N00000X) |
United | P9052 | $576.53 | 1568461572 - WILLIS KNIGHTON MEDICAL CENTER, INC. | 720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTER | LA | 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 P9052 vs. Other Blood and Blood Products, with Associated Procedures Codes
The HCPCS P9052 code is part of the Pathology and Laboratory Services services used for Blood and Blood Products, with Associated Procedures. 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 P9052 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 |
|---|---|---|
| P9051-HCPCS | Moderate | Whole blood or red blood cells, leukocytes reduced, CMV-negative, each unit |
| P9052-HCPCS | Moderate | Platelets, HLA-matched leukocytes reduced, apheresis/pheresis, each unit |
| P9053-HCPCS | Moderate | Platelets, pheresis, leukocytes reduced, CMV-negative, irradiated, each unit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS P9052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the P9052 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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