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See a sample rate comparisonCPT 99050 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.
Medical Services After Hrs, Services Provided In The Office At Times Other Than Regularly Scheduled Office Hours Or Days When The Office Is Normally Closed Eg Holidays Saturday Or Sunday In Addition To Basic Service
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Services, Procedures and Reports |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility None |
| Common Modifiers | None 95 - Telemedicine - audio and video 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99050 |
| Medicaid Fee Schedule | View Medicaid rates for 99050 |
National average reimbursement for CPT 99050 by major payers:
$23.43
$24.28
$20.32
$31.79
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CPT 99050
5 of 25 sample ratesHigher to lower in this preview
Abraham Auerbach
Northwestern Medical Center Inc
$71.22Published rateAparna Sharma
Loyola University Medical Center
$34.74Published rateCorey Goldstein
$31.45Published rateLauren Prest
$26.50Published rateDouglas Lavenburg
Douglas J Lavenburg Md PA
$14.53Published rate
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See a sample payer proposalCPT 99050 vs. Other Special Services, Procedures and Reports Codes
The CPT 99050 code is part of the Medicine Services and Procedures services used for Special Services, Procedures and Reports. 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 99050 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 |
|---|---|---|
| 99026-CPT | Low | Hospital Mandated On Call Service; In-Hospital, Each Hour |
| 99027-CPT | Low | Hospital Mandated On Call Service; Out-Of-Hospital, Each Hour |
| 99050-CPT | Low | Medical Services After Hrs, Services Provided In The Office At Times Other Than Regularly Scheduled Office Hours Or Days When The Office Is Normally Closed Eg Holidays Saturday Or Sunday In Addition To Basic Service |
| 99051-CPT | Low | Additional Office Services, Additional Services Beyond Those Typically Offered Provided In The Physician Office During Regular Extended Hours Such As Evenings Or Weekends. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99050. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99050 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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