HCPCS S0176 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 |
| Complexity Level | Low |
National average reimbursement for HCPCS S0176 by major payers:
$0.67
$0.74
$0.93
$0.80
| 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 S0176 | ||||||
United | S0176 | $0.56 | 1598359234 - ZACHERY EHRENFELT | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0176 | $0.40 | 1851609945 - KRISTI WALLACE | 881358797 - (OR) BRISTOL ADVANCED ILLNESS MANAGEMENT | OR | Family Nurse Practitioner (363LF0000X) |
United | S0176 | $0.56 | 1962515213 - JENNIFER KALATA | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Medical Physician Assistant (363AM0700X) |
United | S0176 | $0.40 | 1659341386 - LEO CYTRYNBAUM | 930975147 - PEACEHEALTH | OR | Hospitalist Physician (208M00000X) |
United | S0176 | $0.56 | 1285658625 - ANN BOWERS | 263095354 - (OR) ICCO, LLC. | OR | Emergency Medicine Physician (207P00000X) |
United | S0176 | $0.40 | 1124242086 - KATHY MELDRUM | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0176 | $0.56 | 1255592838 - ANDREA LEISEROWITZ | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0176 | $0.40 | 1952776023 - KRISTINA JIMENEZ | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | S0176 | $0.56 | 1225257801 - LEIF MEYERS | 454551946 - (ID) TETON VALLEY HEALTH CARE INC | MI | Emergency Medicine Physician (207P00000X) |
United | S0176 | $0.40 | 1780639385 - LEE DAVIDSON | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Emergency Medicine Physician (207P00000X) |
United | S0176 | $0.40 | 1255592838 - ANDREA LEISEROWITZ | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0176 | $1.18 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | S0176 | $1.18 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | S0176 | $4.20 | 1073638490 - SHARRON ACOSTA M.D.P.A. | 742979530 - SHARRON ACOSTA, M.D., P.A. | TX | Ophthalmology Physician (207W00000X) |
United | S0176 | $0.56 | 1548859895 - ALICIA ENCINAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | CA | Family Nurse Practitioner (363LF0000X) |
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 S0176 vs. Other Non-Medicare Drug Codes Codes
The HCPCS S0176 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 S0176 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 |
|---|---|---|
| S0175-HCPCS | Low | Flutamide, oral, 125 mg |
| S0176-HCPCS | Low | Hydroxyurea, oral, 500 mg |
| S0177-HCPCS | Low | Levamisole hydrochloride, oral, 50 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0176. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0176 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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