HCPCS Q4225 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 |
| CMS | $1,370.73 Drug ASP |
National average reimbursement for HCPCS Q4225 by major payers:
$2,267.91
$1,566.33
$1,647.91
$1,642.36
| 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 Q4225 | ||||||
United | Q4225 | $3285.69 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | Q4225 | $1493.50 | 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 | Q4225 | $1459.55 | 1306896253 - HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA, SOUTH GEORGIA MEDICAL CENTER | 586004467 - (GA) HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | Q4225 | $1459.55 | 1972731800 - MERIWETHER HEALTHCARE, L.L.C., WARM SPRINGS MEDICAL CENTER | 870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | Q4225 | $67.60 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | Q4225 | $1459.55 | 1245201094 - SCREVEN COUNTY HOSPITAL | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | Q4225 | $1459.55 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | Q4225 | $1794.96 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | Q4225 | $1794.96 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | Q4225 | $1459.55 | 1033168257 - DUBLIN VAMC | 582080668 - (GA) DUBLIN VAMC | GA | General Acute Care Hospital (282N00000X) |
United | Q4225 | $67.60 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | Q4225 | $41.17 | 1033320049 - ANN STECK | 344428256 - TOLEDO HOSPITAL | OH | Family Medicine Physician (207Q00000X) |
United | Q4225 | $1459.55 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | Q4225 | $1459.55 | 1073567038 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | Q4225 | $1459.55 | 1043785744 - BROOKE CALDWELL | 843505937 - (TX) ATTIGO INFUSION INC | TX | Adult Health Nurse Practitioner (363LA2200X) |
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 Q4225 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4225 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 Q4225 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 |
|---|---|---|
| Q4224-HCPCS | Low | Human health factor 10 amniotic patch (hhf10-p), per square centimeter |
| Q4225-HCPCS | High | Amniobind, per square centimeter |
| Q4226-HCPCS | Moderate | MyOwn skin, includes harvesting and preparation procedures, per square centimeter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4225 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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