HCPCS Q0163 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 • Chemotherapy Anti-emetic Medications |
| Complexity Level | Low |
| Related NDC Codes | • 00113-0379-26 - GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (ALCOHOL FREE,CHERRY) 12.5 MG/5 ML • 00113-0479-62 - GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (EASY TO SWALLOW) 25 MG • 00113-0479-78 - GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (EASY TO SWALLOW) 25 MG • 00121-0489-00 - DIPHENHYDRAMINE HCL 12.5 MG/5 ML • 00121-0489-05 - DIPHENHYDRAMINE HCL 12.5 MG/5 ML |
National average reimbursement for HCPCS Q0163 by major payers:
$0.11
$0.08
$0.05
$0.16
| 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 Q0163 | ||||||
United | Q0163 | $0.03 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q0163 | $0.02 | 1669475737 - MARVIN FOJTASEK | 843505937 - (TX) ATTIGO INFUSION INC | TX | Infectious Disease Physician (207RI0200X) |
United | Q0163 | $0.01 | 1669769782 - JULIO BERAS-MATOS | 562613565 - (TX) ARTHRITIS ASSOCIATES, P.A. | TX | Rheumatology Physician (207RR0500X) |
United | Q0163 | $0.02 | 1598476814 - JENNIFER WALKER | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q0163 | $0.01 | 1043785744 - BROOKE CALDWELL | 843505937 - (TX) ATTIGO INFUSION INC | TX | Adult Health Nurse Practitioner (363LA2200X) |
United | Q0163 | $0.02 | 1326209800 - JAMES FRANCESCONI | 843505937 - (TX) ATTIGO INFUSION INC | TX | Neurology Physician (2084N0400X) |
United | Q0163 | $0.01 | 1699050633 - DONNA FLEMING | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q0163 | $0.02 | 1710525225 - MARY OSAWE | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q0163 | $0.02 | 1780799015 - DALE YOO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | Q0163 | $0.01 | 1881179588 - MARY EZEBUIRO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q0163 | $0.01 | 1891339644 - ATTIGO INFUSION INC, MEDIX INFUSION | 843505937 - (TX) ATTIGO INFUSION INC | TX | Infectious Disease Physician (207RI0200X) |
United | Q0163 | $0.01 | 1205582053 - JESSICA ALVAREZ-ORTIZ | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q0163 | $0.04 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | Q0163 | $0.04 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | Q0163 | $0.02 | 1669475737 - MARVIN FOJTASEK | 843505937 - (TX) ATTIGO INFUSION INC | TX | Infectious Disease Physician (207RI0200X) |
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 Q0163 vs. Other Chemotherapy Anti-emetic Medications Codes
The HCPCS Q0163 code is part of the Temporary Codes services used for Chemotherapy Anti-emetic Medications. 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 Q0163 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 |
|---|---|---|
| 00113-0379-26-NDC | Moderate | GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (ALCOHOL FREE,CHERRY) 12.5 MG/5 ML |
| 00113-0479-62-NDC | Moderate | GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (EASY TO SWALLOW) 25 MG |
| 00113-0479-78-NDC | Moderate | GOOD SENSE ANTIHISTAMINE ALLERGY RELIEF (EASY TO SWALLOW) 25 MG |
| Q0163-HCPCS | Low | Diphenhydramine hydrochloride, 50 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q0163. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q0163 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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