HCPCS T1505 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 | • National Codes Established for State Medicaid Agencies • Miscellaneous Services and Supplies |
| Common Place of Service | • None • 99 - Other Place of Service |
| Common Modifiers | |
| Complexity Level | Moderate |
National average reimbursement for HCPCS T1505 by major payers:
$72.73
$54.00
$21.13
$N/A
| 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 T1505 | ||||||
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HCPCS T1505 vs. Other Miscellaneous Services and Supplies Codes
The HCPCS T1505 code is part of the National Codes Established for State Medicaid Agencies services used for Miscellaneous Services and Supplies. 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 T1505 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 |
|---|---|---|
| T1503 | Low | Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit |
| T1505 | Low | Electronic medication compliance management device, includes all components and accessories, not otherwise classified |
| T1999 | Low | Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS T1505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the T1505 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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