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See a sample rate comparisonHCPCS P9604 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.
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Services Specimen Collection, Travel Allowance |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for P9604 |
National average reimbursement for HCPCS P9604 by major payers:
$7.00
$12.58
$8.40
$6.96
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HCPCS P9604
5 of 25 sample ratesHigher to lower in this preview
Progressive Emergency Physicians PLLC
$31.93Published rateUjuka Iloabuchi
$19.21Published rateIrwin County Hospital
$14.50Published rateHospital Authority Of Jenkins County
$10.47Published rateAlicia Encinas
Miguel A Arenas Md PC
$8.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS P9604 vs. Other Specimen Collection, Travel Allowance Codes
The HCPCS P9604 code is part of the Pathology and Laboratory Services services used for Specimen Collection, Travel Allowance. 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 P9604 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 |
|---|---|---|
| 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 |
| P9604-HCPCS | Low | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge. |
| P9612-HCPCS | Low | Catheterization for collection of specimen, single patient, all places of service |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS P9604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the P9604 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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