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See a sample rate comparisonHCPCS S5550 Fee Schedule
Last Verified: October 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.
Insulin, rapid onset, 5 units
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Insulin and Delivery Devices |
| Common Place of Service | None 11 - Office 23 - Emergency Room |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for S5550 |
National average reimbursement for HCPCS S5550 by major payers:
$0.28
$0.25
$1.08
$0.45
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HCPCS S5550
5 of 25 sample ratesHigher to lower in this preview
Jennifer Kalata
Willamette Community Health Solutions
$0.23Published rateNatalia Hayes
Doctors Emergency Room Corp PC
$0.23Published rateKristi Wallace
Bristol Advanced Illness Management
$0.23Published rateDaniel Zimmerman
$0.23Published rateAnn Bowers
Icco, LLC.
$0.23Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS S5550 vs. Other Insulin and Delivery Devices Codes
The HCPCS S5550 code is part of the Temporary National Codes (Non-Medicare) services used for Insulin and Delivery Devices. 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 S5550 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 |
|---|---|---|
| S5523-HCPCS | Low | Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) |
| S5550-HCPCS | Low | Insulin, rapid onset, 5 units |
| S5551-HCPCS | Low | Insulin, most rapid onset (Lispro or Aspart); 5 units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S5550. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S5550 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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