HCPCS Q4011 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 • Cast and Splint Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS Q4011 by major payers:
$4.61
$2.89
$4.69
$4.41
| 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 Q4011 | ||||||
United | Q4011 | $2.28 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | Q4011 | $2.53 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | Q4011 | $9.85 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4011 | $9.85 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4011 | $2.97 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | Q4011 | $2.59 | 1376139568 - ELLEN LONSDALE | 821489314 - (TX) N J CARING LLC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4011 | $3.50 | 1033435664 - SMITH OF GEORGIA, SMITH NORTHVIEW HOSPITALISTS | 271652335 - (GA) SMITH OF GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | Q4011 | $5.92 | 1306136551 - UJUKA ILOABUCHI | 474870066 - (GA) GWINNETT OBGYN ASSOCIATES OF GEORGIA LLC | GA | Women's Hospital (282NW0100X) |
United | Q4011 | $2.56 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTY | GA | Rural Acute Care Hospital (282NR1301X) |
United | Q4011 | $1.90 | 1669769782 - JULIO BERAS-MATOS | 562613565 - (TX) ARTHRITIS ASSOCIATES, P.A. | TX | Rheumatology Physician (207RR0500X) |
United | Q4011 | $2.28 | 1508900101 - MICHAEL KOCH | 208418894 - (GA) PATHOLOGY LAB OF GEORGIA LLC | GA | General Acute Care Hospital (282N00000X) |
United | Q4011 | $1.90 | 1285644427 - JOSE ROLDAN | 562613565 - (TX) ARTHRITIS ASSOCIATES, P.A. | TX | Rheumatology Physician (207RR0500X) |
United | Q4011 | $1.90 | 1053380048 - PENDLETON WICKERSHAM | 562613565 - (TX) ARTHRITIS ASSOCIATES, P.A. | TX | Rheumatology Physician (207RR0500X) |
United | Q4011 | $3.50 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | Q4011 | $2.41 | 1326028978 - CHATUGE REGIONAL HOSPITAL INC | 582513901 - CHATUGE REGIONAL HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
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 Q4011 vs. Other Cast and Splint Supplies Codes
The HCPCS Q4011 code is part of the Temporary Codes services used for Cast and Splint Supplies. 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 Q4011 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 |
|---|---|---|
| Q4010-HCPCS | Low | Cast supplies, short arm cast, adult (11 years +), fiberglass |
| Q4011-HCPCS | Low | Cast supplies, short arm cast, pediatric (0-10 years), plaster |
| Q4012-HCPCS | Low | Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4011 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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