HCPCS Q0091 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 | • Temporary Codes • Miscellaneous Drugs and Tests |
| Complexity Level | Low |
| CMS | $43.34 Physician Fee Schedule |
National average reimbursement for HCPCS Q0091 by major payers:
$51.51
$52.57
$53.61
$48.01
| 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 Q0091 | ||||||
United | Q0091 | $15.59 | 1487728127 - JOSE CISNEROS | 274174150 | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $67.00 | 1497075105 - ANIKA CHERRY | 832048888 | NC | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $68.01 | 1548526452 - VICTORIA MOORE | 201838374 | MD | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $127.95 | 1366599755 - EHAB ABDELMALEK | 131623978 | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $97.88 | 1164687497 - CHIOMA NDUBISI | 232729852 - CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH | PA | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $106.31 | 1336236371 - TRACY RUYMANN | 870737749 | CA | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $61.88 | 1902829047 - ADAM JACOBS | 611661781 | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $38.31 | 1952369837 - HITESH NARAIN | 113573788 | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $31.72 | 1538192323 - FELIX ANDARSIO | 201306647 | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $87.33 | 1063594612 - KEVIN FULFORD | 800307419 | CA | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $75.12 | 1275596959 - ANGELA CHAUDHARI | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $61.15 | 1568447837 - NITA RANA | 150532254 - ST JOSEPHS HOSPITAL HEALTH CENTER | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $61.36 | 1124128178 - JOAN ALTMAN NEUMANN | 113492255 | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $67.94 | 1780796805 - BRIAN ROGERS | 454832340 | NJ | Obstetrics & Gynecology Physician (207V00000X) |
United | Q0091 | $48.79 | 1093805327 - ANGELA MESSINA | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | MI | Obstetrics & Gynecology Physician (207V00000X) |
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 Q0091 vs. Other Miscellaneous Drugs and Tests Codes
The HCPCS Q0091 code is part of the Temporary Codes services used for Miscellaneous Drugs and Tests. 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 Q0091 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 |
|---|---|---|
| Q0085-HCPCS | Low | Chemotherapy administration by both infusion technique and other technique(s) e.g., subcutaneous, intramuscular, push), per visit |
| Q0091-HCPCS | Low | Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
| Q0092-HCPCS | Low | Set-up portable X-ray equipment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q0091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q0091 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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