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See a sample rate comparisonHCPCS Q0164 (Prochlorperazine Maleate) 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.
Prochlorperazine maleate, 5 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Chemotherapy Anti-emetic Medications |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for Q0164 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00904-7381-06 - PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 5 MG • 00904-7382-06 - PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 10 MG • 27241-0286-01 - PROCHLORPERAZINE MALEATE USP,FILM-COATED 5 MG • 27241-0287-01 - PROCHLORPERAZINE MALEATE USP,FILM-COATED 10 MG • 38779-0180-04 - PROCHLORPERAZINE MALEATE (U.S.P.) |
National average reimbursement for HCPCS Q0164 by major payers:
$0.36
$0.38
$0.37
$0.40
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HCPCS Q0164
5 of 25 sample ratesHigher to lower in this preview
Leonger Malpica
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$0.34Published rateLindsay Power
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$0.34Published rateHarsheel Desai
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$0.34Published rateYolanda Pina
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$0.34Published rateTrenton Avriett
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$0.34Published rate
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See a sample payer proposalHCPCS Q0164 vs. Other Chemotherapy Anti-emetic Medications Codes
The HCPCS Q0164 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 Q0164 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 |
|---|---|---|
| 00904-7381-06-NDC | Moderate | PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 5 MG |
| 00904-7382-06-NDC | Moderate | PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 10 MG |
| 27241-0286-01-NDC | Moderate | PROCHLORPERAZINE MALEATE USP,FILM-COATED 5 MG |
| Q0164-HCPCS | Low | Prochlorperazine maleate, 5 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at the 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 Q0164. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q0164 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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