HCPCS Q4206 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 • Skin Substitutes and Biologicals |
| Complexity Level | High |
National average reimbursement for HCPCS Q4206 by major payers:
$2,160.11
$2,128.06
$2,442.05
$49.63
| 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 Q4206 | ||||||
United | Q4206 | $2060.00 | 1306890942 - BROOKS COUNTY HOSPITAL | 586002830 | GA | Critical Access Hospital (282NC0060X) |
United | Q4206 | $2101.19 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | Q4206 | $2060.00 | 1083221717 - CLARE ROEWE | 461432420 - IVXPRESS, INC. DBA IVX HEALTH | KS | Family Nurse Practitioner (363LF0000X) |
United | Q4206 | $2060.00 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $7007.43 | 1720589328 - PIEDMONT WALTON HOSPITAL INC | 824194264 - (GA) PIEDMONT WALTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | Q4206 | $2448.00 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $2060.00 | 1306136551 - UJUKA ILOABUCHI | 582483738 | GA | Women's Hospital (282NW0100X) |
United | Q4206 | $2448.00 | 1578866737 - CORAM ALTERNATE SITE SERVICES INC | 760215922 | FL | Home Infusion Therapy Pharmacy (3336H0001X) |
United | Q4206 | $2060.00 | 1598476814 - JENNIFER WALKER | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4206 | $2060.00 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | Q4206 | $4326.00 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $2448.00 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $2448.00 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $4532.00 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4206 | $2060.00 | 1548859895 - ALICIA ENCINAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | CA | Family Nurse Practitioner (363LF0000X) |
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 Q4206 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4206 code is part of the Temporary Codes services used for Skin Substitutes and Biologicals. 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 Q4206 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 |
|---|---|---|
| Q4205-HCPCS | High | Membrane graft or membrane wrap, per square centimeter |
| Q4206-HCPCS | High | Fluid flow or fluid GF, 1 cc |
| Q4208-HCPCS | Moderate | Novafix, per square cenitmeter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4206 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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