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See a sample rate comparisonCPT 80299 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.
Medication Therapy Monitoring, This Analysis Is Performed To Determine The Correct Dose Of A Therapeutic Drug Or To Monitor A Drug For Potential Adverse Effects.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $18.64 national lab fee schedule rate (2026) · View Medicare rates for 80299 |
| Medicaid Fee Schedule | $18.405 median of the 8 states in the free preview · View Medicaid rates for 80299 |
National average reimbursement for CPT 80299 by major payers:
$15.29
$36.31
$19.65
$25.61
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CPT 80299
5 of 25 sample ratesHigher to lower in this preview
Robin Mendelsohn
Memorial Gastroenterology Group
$54.43Published rateCherif El Younis
Brookdale Family Care Centers Inc
$11.56Published rateSandra Layne
Sandra Layne, M.D.
$8.39Published rateAlan Sloyer
Gastrointestinal Care Of Long Is
$7.82Published rateJoel Baum
New York City Health And Hospitals Corporation
$6.59Published rate
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See a sample payer proposalCPT 80299 vs. Other Therapeutic Drug Assays Codes
The CPT 80299 code is part of the Pathology and Laboratory Procedures services used for Therapeutic Drug Assays. 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 CPT 80299 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 |
|---|---|---|
| 80230-CPT | Low | Infliximab, A Lab Test For Infliximab. This Drug Is Typically Used To Treat Autoimmune Disorders Including Rheumatoid Arthritis And Inflammatory Bowel Disease. |
| 80235-CPT | Low | Lacosamide, A Lab Test For Lacosamide. This Drug Is Used Primarily To Treat Seizures In Combination With Other Drugs. |
| 80280-CPT | Low | Vedolizumab, A Lab Test For Vedolizumab. This Drug Is Generally Used To Treat Ulcerative Colitis And Crohns Disease. |
| 80299-CPT | Low | Medication Therapy Monitoring, This Analysis Is Performed To Determine The Correct Dose Of A Therapeutic Drug Or To Monitor A Drug For Potential Adverse Effects. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80299. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80299 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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