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See a sample rate comparisonHCPCS P9100 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.
Pathogen(s) test for platelets
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Services Blood and Blood Products, with Associated Procedures |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for P9100 |
National average reimbursement for HCPCS P9100 by major payers:
$141.57
$21.08
$50.59
$39.03
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HCPCS P9100
5 of 25 sample ratesHigher to lower in this preview
Emanuel County Hospital Authority, Emanuel Medical Center
$46.25Published rateSurgical Specialty Center Of Baton Rouge, LLC, Surgical Specialty Center Of Baton Rouge
Surgical Specialty Center Of Baton Rouge, LLC
$35.50Published ratePiedmont Mountainside Hospital, Inc., Piedmont Mountainside Hospital
Piedmont Mountainside Hospital Inc
$22.95Published ratePiedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$22.95Published rateTouro Infirmary
$15.30Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS P9100 vs. Other Blood and Blood Products, with Associated Procedures Codes
The HCPCS P9100 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 P9100 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 |
|---|---|---|
| P9099-HCPCS | Low | Blood component or product not otherwise classified |
| P9100-HCPCS | Low | Pathogen(s) test for platelets |
| P9603-HCPCS | Low | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS P9100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the P9100 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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