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See a sample rate comparisonHCPCS S0199 Fee Schedule
Last Verified: September 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.
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by HCG, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Miscellaneous Provider Services |
| Common Place of Service | 11 - Office None |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for S0199 |
National average reimbursement for HCPCS S0199 by major payers:
$447.48
$568.53
$337.42
$385.80
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HCPCS S0199
3 of 3 sample ratesHigher to lower in this preview
Sophie Dojacques
Cheshire Medical Center
$1,017.47Published rateJeanne-Marie Guise
Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc
$838.21Published rateJeanne-Marie Guise
Beth Israel Deaconess Medical Center Inc
$838.21Published rate
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See a sample payer proposalHCPCS S0199 vs. Other Miscellaneous Provider Services Codes
The HCPCS S0199 code is part of the Temporary National Codes (Non-Medicare) services used for Miscellaneous Provider Services. 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 S0199 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 |
|---|---|---|
| S0197-HCPCS | Low | Prenatal vitamins, 30-day supply |
| S0199-HCPCS | Moderate | Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by HCG, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
| S0201-HCPCS | Low | Partial hospitalization services, less than 24 hours, per diem |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0199. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0199 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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