HCPCS Q4294 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 Q4294 by major payers:
$1,174.96
$2,793.21
$N/A
$3,742.04
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | Q4294 | $2850.62 | 1760131486 - GISELA CHIN | 270099163 - (NV) POUYA MOHAJER M D LTD | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4294 | $2850.62 | 1811998636 - CARMEN ESPITIA | 261937235 - (NV) ADELANTE FAMILY MEDICAL CLINIC | NV | Family Medicine Physician (207Q00000X) |
United | Q4294 | $2279.00 | 1881709574 - VICKIE TIPPETT | 880122015 - (NV) OB-GYN ASSOCIATES, LTD. | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | Q4294 | $2850.62 | 1558319822 - MICHAEL GUNTER | 880387993 - (NV) MICHAEL J GUNTER LTD | NV | Family Medicine Physician (207Q00000X) |
United | Q4294 | $2734.80 | 1295891687 - KARYN OFA | 1295891687 - (NV) KARYN OFA | NV | Internal Medicine Physician (207R00000X) |
United | Q4294 | $2850.62 | 1891141446 - DANIEL DIAZ | 813419791 - (NV) UNLV MEDICINE | NV | Sports Medicine (Family Medicine) Physician (207QS0010X) |
United | Q4294 | $2850.62 | 1447867874 - CAITLIN RAMSEY | 454731155 - (NV) K. SASSE SURGICAL ASSOCIATES | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4294 | $3000.00 | 1427280874 - JESSICA ENDERS | 1427280874 - (NV) JESSICA ENDERS | NV | Registered Dietitian (133V00000X) |
United | Q4294 | $2279.00 | 1366849614 - MARIA KEAVENEY | 271668976 - (KY) MNT INC | NV | Registered Dietitian (133V00000X) |
United | Q4294 | $2279.00 | 1558757401 - DANIEL HILTON | 920377684 - (NV) ADVANCED EAR NOSE THROATHEAD AND NECK SURGERY LLC | NV | Otolaryngology Physician (207Y00000X) |
United | Q4294 | $2850.62 | 1063195675 - JOYCE DEL ROSARIO | 200160881 - INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4294 | $2279.00 | 1689605545 - ANDREW WESELY | 842435357 - (NV) ALI NAIRIZI MD PC | NV | Specialist (174400000X) |
United | Q4294 | $2565.57 | 1750404182 - THOMAS KING HALOW MDS LTD, CARSON SURGICAL GROUP | 880106584 - (NV) THOMAS, KING, & HALOW, MDS, LTD. | NV | Surgery Physician (208600000X) |
United | Q4294 | $3135.00 | 1659387934 - NEVADA HEART AND VASCULAR CENTER RESH LLP, NEVADA HEART AND VASCULAR CENTER | 1659387934 - (NV) NEVADA HEART AND VASCULAR CENTER RESH LLP | NV | Cardiovascular Disease Physician (207RC0000X) |
United | Q4294 | $2279.00 | 1609856095 - QUINTON THOMAS | 931307555 | NV | Family Medicine Physician (207Q00000X) |
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 Q4294 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4294 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 Q4294 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 |
|---|---|---|
| Q4294-HCPCS | High | Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4294. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4294 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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