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HCPCS Q0169 (Promethazine Hcl) Fee Schedule

Last Verified: January 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.

Promethazine hydrochloride, 12.5 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 FactDetail
Service Type

Temporary Codes

Chemotherapy Anti-emetic Medications

Complexity LevelLow
WAC Price
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Related NDC Codes

00116-4023-16 - PROMETHAZINE HCL STRAWBERRY, BANANA, FRUIT 6.25 MG/5 ML

00121-1854-16 - PROMETHAZINE HCL APPLE-WATERMELON 6.25 MG/5 ML

00591-5307-01 - PROMETHAZINE HCL 25 MG

00591-5307-10 - PROMETHAZINE HCL 25 MG

00591-5319-01 - PROMETHAZINE HCL 50 MG


National average reimbursement for HCPCS Q0169 by major payers:

bcbs

$0.15

uhc

$0.10

aetna

$0.20

cigna

$0.20

Preview provider-level rates for...
For billing codeHCPCS Q0169
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS Q0169

United
Q0169$0.281376574277 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL FORSYTH581954432 - (GA) NORTHSIDE HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.071417157405 - EMORY HEALTHCARE711018941 - CARDIAC ARRHYTHMIA INSTITUTEGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.231225281603 - EMORY CRAWFORD LONG HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.071548859895 - ALICIA ENCINAS300394179 - (AZ) MIGUEL A ARENAS MD PCCAFamily Nurse Practitioner (363LF0000X)
United
Q0169$0.071063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
Q0169$0.081003596248 - SHELBY MOSES843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0169$0.071205890076 - APRIL LEUZINGER271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
Q0169$0.071316561236 - CINDY CHANG300394179 - (AZ) MIGUEL A ARENAS MD PCAZFamily Nurse Practitioner (363LF0000X)
United
Q0169$0.071174512115 - MICHAEL GUILLETTE271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
Q0169$0.071497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS273100894GACritical Access Hospital (282NC0060X)
United
Q0169$0.551437186111 - PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.582179986 - (GA) PIEDMONT ATHENS REGIONAL MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.761457396079 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL581954432 - (GA) NORTHSIDE HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.281396923710 - EMORY UNIVERSITY HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
Q0169$0.071326079260 - HOSPITAL AUTHORITY OF LIBERTY COUNTY, LIBERTY REGIONAL MEDICAL CENTER586025016GACritical Access Hospital (282NC0060X)
United
Q0169$0.071427189927 - DEVON DANEY271495988 - (NM) AZTEC URGENT CARE LLCCOFamily Medicine Physician (207Q00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS Q0169 vs. Other Chemotherapy Anti-emetic Medications Codes

The HCPCS Q0169 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 Q0169 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.

CodeComplexityDescription
00116-4023-16-NDCModeratePROMETHAZINE HCL STRAWBERRY, BANANA, FRUIT 6.25 MG/5 ML
00121-1854-16-NDCModeratePROMETHAZINE HCL APPLE-WATERMELON 6.25 MG/5 ML
00591-5307-01-NDCModeratePROMETHAZINE HCL 25 MG
Q0169-HCPCSLowPromethazine hydrochloride, 12.5 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 Q0169. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the Q0169 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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