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See a sample rate comparisonHCPCS Q0113 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.
Pinworm examinations
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Miscellaneous Drugs and Tests |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for Q0113 |
National average reimbursement for HCPCS Q0113 by major payers:
$4.30
$4.52
$4.63
$3.79
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HCPCS Q0113
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$9.39Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$7.11Published rateClhg-Leesville, Byrd Regional Hospital
$4.53Published rateOur Lady Of The Lake Assumption Community Hospital, Assumption Community Hospital
Our Lady Of The Lake Assumption Community Hospital Inc
$4.26Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$2.81Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS Q0113 vs. Other Miscellaneous Drugs and Tests Codes
The HCPCS Q0113 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 Q0113 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 |
|---|---|---|
| Q0112-HCPCS | Low | All potassium hydroxide (KOH) preparations |
| Q0113-HCPCS | Low | Pinworm examinations |
| Q0114-HCPCS | Low | Fern test |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q0113. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q0113 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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