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HCPCS S0013 Fee Schedule

Last Verified: February 2026

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.

Esketamine, nasal spray, 1 mg
Key FactDetail
Service Type

Temporary National Codes (Non-Medicare)

Non-Medicare Drug Codes

Common Place of Service

11 - Office

None

Complexity LevelLow

National average reimbursement for HCPCS S0013 by major payers:

bcbs

$14.27

uhc

$14.51

aetna

$14.36

cigna

$14.34

Preview provider-level rates for...
For billing codeHCPCS S0013
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS S0013

United
S0013$14.071366548141 - MARK CANNING270444414 - GARDEN STATE HEALTHCARE ASSOCIATES, LLCNJPsychiatric/Mental Health Nurse Practitioner (363LP0808X)
United
S0013$13.531255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
S0013$15.761518196401 - ANN TUSZYNSKI232343001NJClinical Social Worker (1041C0700X)
United
S0013$23.841194927863 - GREGORY FERNANDEZ133430629 - MEMORIAL PSYCHIATRY GROUPNJPsychiatry Physician (2084P0800X)
United
S0013$20.181174029565 - ANDREW CHEN223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PCNJPsychiatry Physician (2084P0800X)
United
S0013$15.761598795536 - ERIC MALZ132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNJPsychiatric/Mental Health Nurse Practitioner (363LP0808X)
United
S0013$13.461255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
S0013$24.001194927863 - GREGORY FERNANDEZ300937486NJPsychiatry Physician (2084P0800X)
United
S0013$13.401073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
S0013$12.181255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
S0013$13.521053401976 - MICHELLE CASTELLANI200469753 - MARON & RODRIGUES MEDICAL GROUP LLCNJClinical Social Worker (1041C0700X)
United
S0013$13.521043523657 - HUMA ANSARI223586872NJPsychiatry Physician (2084P0800X)
United
S0013$11.501215192877 - SUZANNE FLOYD223624559 - RIVERSIDE MEDICAL GROUPNJPsychiatric/Mental Health Nurse Practitioner (363LP0808X)
United
S0013$13.521649928029 - GALINA MAGUIRE205594398 - RITU SURI MD LLCNJPsychiatric/Mental Health Nurse Practitioner (363LP0808X)
United
S0013$13.531255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS S0013 vs. Other Non-Medicare Drug Codes Codes

The HCPCS S0013 code is part of the Temporary National Codes (Non-Medicare) services used for Non-Medicare Drug Codes. 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 S0013 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.

CodeComplexityDescription
S0012-HCPCSLowButorphanol tartrate, nasal spray, 25 mg
S0013-HCPCSLowEsketamine, nasal spray, 1 mg
S0014-HCPCSLowTacrine hydrochloride, 10 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the S0013 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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