HCPCS Q2055 (Abecma) Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Temporary Codes • Other Drugs and Service Fees |
| Complexity Level | High |
| Medicare Payment Limit | $557317.934  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS Q2055 by major payers:
$343,046.12
$591,349.93
$519,064.42
$567,000.13
| 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 Q2055 | ||||||
United | Q2055 | $571934.56 | 1639149545 - MARK FESEN | 481125116 - CENTRAL CARE PA | KS | Medical Oncology Physician (207RX0202X) |
United | Q2055 | $503454.53 | 1689622748 - MEDICAL ONCOLOGY ASSOCIATES AT SAINT BARNABAS | 223403774 - (NJ) MEDICAL ONCOLOGY ASSOCIATES AT SAINT BARNABAS | NJ | Medical Oncology Physician (207RX0202X) |
United | Q2055 | $470972.65 | 1497982771 - TIMOTHY VREELAND | 263290360 - (MO) MERCY CLINIC ST LOUIS CANCER AND BREAST INSTITUTE LLC | MO | Surgical Oncology Physician (2086X0206X) |
United | Q2055 | $679886.68 | 1780662361 - STEPHEN SZABO | 582540874 | GA | Hematology & Oncology Physician (207RH0003X) |
United | Q2055 | $533661.81 | 1821246760 - CAROLINAS PHYSICIANS NETWORK INC, CAROLINA CANCER SPECIALISTS | 562217537 - CAROLINA CANCER SPECIALISTS, P.A. | SC | Hematology & Oncology Physician (207RH0003X) |
United | Q2055 | $499231.00 | 1669458931 - MARGARET AKPAN | 521819213 | MD | Hematology & Oncology Physician (207RH0003X) |
United | Q2055 | $499231.00 | 1902835374 - MICHAEL SMITH | 593569143 - (FL) CENTRAL FLORIDA CANCER INSTITUTE PA | FL | Radiation Oncology Physician (2085R0001X) |
United | Q2055 | $499231.00 | 1023093168 - JEFFREY GEFTER | 621138684 - JEFFREY W. GEFTER, M.D., P.C. | TN | Radiation Oncology Physician (2085R0001X) |
United | Q2055 | $533661.81 | 1376779892 - BAPTIST MEDICAL GROUP LLC | 264800380 | FL | Hematology & Oncology Physician (207RH0003X) |
United | Q2055 | $447424.03 | 1053342154 - NAVNEET MAJHAIL | 474541197 - (TN) TRISTAR BONE MARROW TRANSPLANT LLC | TN | Hematology (Internal Medicine) Physician (207RH0000X) |
United | Q2055 | $470972.65 | 1497982771 - TIMOTHY VREELAND | 263290360 - (MO) MERCY CLINIC ST LOUIS CANCER AND BREAST INSTITUTE LLC | MO | Surgical Oncology Physician (2086X0206X) |
United | Q2055 | $560450.62 | 1790768125 - MICHAEL MARCHESE | 223333450 - (NJ) JERSEY SHORE BRACHYTHERAPY P A | NJ | Radiation Oncology Physician (2085R0001X) |
United | Q2055 | $499231.00 | 1760473185 - HARVEY BALFOUR | 300366366 - (TN) EAST TENNESSEE RADIATION ONCOLOGY, PC | SC | Radiation Oncology Physician (2085R0001X) |
United | Q2055 | $436221.28 | 1093178121 - SUSHMITA GORDHANDAS | 522112078 - (MD) CAPITAL WOMENS CARE, LLC | VA | Gynecologic Oncology Physician (207VX0201X) |
United | Q2055 | $470972.65 | 1891946349 - MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC, ST LOUIS CANCER AND BREAST INSTITUTE | 263290360 - (MO) MERCY CLINIC ST LOUIS CANCER AND BREAST INSTITUTE LLC | MO | Surgical Oncology Physician (2086X0206X) |
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 Q2055 vs. Other Other Drugs and Service Fees Codes
The HCPCS Q2055 code is part of the Temporary Codes services used for Other Drugs and Service Fees. 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 Q2055 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 |
|---|---|---|
| Q2054-HCPCS | High | Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| Q2055-HCPCS | High | Idecabtagene vicleucel, up to 460 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| Q2056-HCPCS | High | Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q2055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q2055 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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