HCPCS Q4236 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 • Skin Substitutes and Biologicals |
| Complexity Level | Moderate |
| CMS | $483.65 Drug ASP |
National average reimbursement for HCPCS Q4236 by major payers:
$562.48
$540.02
$568.17
$530.61
| 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 Q4236 | ||||||
United | Q4236 | $1681.56 | 1508944992 - IRINA PROSHKINA | 870737748 | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $767.00 | 1235561671 - SARAH CHAFFIN | 821926135 | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $613.59 | 1063798940 - RIMON ISSAC D.O. INC | 680368632 - (CA) RIMON ISSAC DO INC | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $613.59 | 1487689840 - JOHN JACKSON | 680124454 - (CA) SIERRA DOCTORS MEDICAL GROUP | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $613.59 | 1346770724 - ORIN HANSEN | 810384618 - (MT) BIG HORN HOSPITAL ASSOCIATION | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $1647.94 | 1275567448 - SCRIPPS HEALTH, SCRIPPS MEDICAL FOUNDATION | 870737748 | CA | Family Medicine Physician (207Q00000X) |
United | Q4236 | $1647.94 | 1922038512 - MICHAEL DEVEREAUX | 870737748 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $613.59 | 1447200480 - RAJINA RANADIVE | 542192558 - (CA) RANADIVE MD INC | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $1647.94 | 1710446539 - RUJING SHI | 870737748 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $650.41 | 1285016113 - CHANGHYUN KIM | 815309615 | CA | Dermatology Physician (207N00000X) |
United | Q4236 | $1681.56 | 1922038512 - MICHAEL DEVEREAUX | 870737748 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $1647.94 | 1083117865 - KEVIN DIEP | 870737748 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $613.59 | 1023108925 - STELLA POPOVA | 810576270 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $1681.56 | 1083117865 - KEVIN DIEP | 870737748 | CA | Internal Medicine Physician (207R00000X) |
United | Q4236 | $613.59 | 1922417385 - DIONICIA MACIAS | 800725733 - (TX) HNI MEDICAL SERVICES | CA | Nurse Practitioner (363L00000X) |
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 Q4236 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4236 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 Q4236 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 |
|---|---|---|
| Q4235-HCPCS | Low | Amniorepair or altiply, per square centimeter |
| Q4236-HCPCS | Moderate | Carepatch, per square centimeter |
| Q4237-HCPCS | Moderate | Cryo-cord, 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 Q4236. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4236 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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