HCPCS S0092 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 National Codes (Non-Medicare) • Non-Medicare Drug Codes |
| Common Place of Service | • None • 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS S0092 by major payers:
$71.57
$85.34
$89.43
$90.17
| 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 S0092 | ||||||
United | S0092 | $83.40 | 1558591768 - ASHLEY RIGGS | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0092 | $83.40 | 1316938459 - NAVICENT HEALTH OCONEE, LLC, NAVICENT HEALTH BALDWIN | 582359398 - NAVICENT HEALTH OCONEE LLC | GA | General Acute Care Hospital (282N00000X) |
United | S0092 | $83.40 | 1083883136 - SCOTT COLLING | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0092 | $83.40 | 1477714467 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, OCCUPATIONAL HEALTH SERVICES | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Specialist (174400000X) |
United | S0092 | $83.40 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | S0092 | $83.40 | 1871310847 - YANAN XUE | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Registered Dietitian (133V00000X) |
United | S0092 | $83.40 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | S0092 | $83.40 | 1942629126 - AMBER VESTER | 931173927 | OR | Family Medicine Physician (207Q00000X) |
United | S0092 | $83.40 | 1780639385 - LEE DAVIDSON | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Emergency Medicine Physician (207P00000X) |
United | S0092 | $83.40 | 1871991026 - CASEY ROSSBERG | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Occupational Therapist (225X00000X) |
United | S0092 | $83.40 | 1497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | S0092 | $83.40 | 1962925925 - BRITTANY REEVES | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0092 | $83.40 | 1962515213 - JENNIFER KALATA | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Medical Physician Assistant (363AM0700X) |
United | S0092 | $83.40 | 1720590987 - PAMELA COTTON | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Family Nurse Practitioner (363LF0000X) |
United | S0092 | $83.40 | 1285658625 - ANN BOWERS | 263095354 - (OR) ICCO, LLC. | OR | Emergency Medicine Physician (207P00000X) |
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 S0092 vs. Other Non-Medicare Drug Codes Codes
The HCPCS S0092 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 S0092 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 |
|---|---|---|
| S0091-HCPCS | Low | Granisetron hydrochloride, 1 mg (for circumstances falling under the Medicare statute, use Q0166) |
| S0092-HCPCS | Low | Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump) |
| S0093-HCPCS | Low | Injection, morphine sulfate, 500 mg (loading dose for infusion pump) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0092. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0092 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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