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See a sample rate comparisonCPT 99060 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.
Out Of Office Emerg Med Serv, Service S Provided On An Emergency Basis Out Of The Office Which Disrupts Other Scheduled Office Services In Addition To Basic Service
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Services, Procedures and Reports |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 95 - Telemedicine - audio and video 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99060 |
| Medicaid Fee Schedule | View Medicaid rates for 99060 |
National average reimbursement for CPT 99060 by major payers:
$35.75
$32.39
$21.18
$50.72
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CPT 99060
5 of 25 sample ratesHigher to lower in this preview
Trilok Shah
Ascension Medical Group-Fox Valley Wisconsin Inc
$76.20Published rateMary Fahrmeier
$47.33Published rateElizabeth Harari
$45.31Published rateAshley Mulvihill
The Board Of Trustees Of The University Of Illinois
$38.81Published rateChristopher Johnson
Southern Illinois Healthcare Foundation Inc
$19.54Published rate
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See a sample payer proposalCPT 99060 vs. Other Special Services, Procedures and Reports Codes
The CPT 99060 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 99060 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 |
|---|---|---|
| 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. |
| 99053-CPT | Low | After Hours Services, After Hours Services Are Provided In The Doctors Office Outside Typical Business Hours But At Times An Office Is Open. This May Include Hours On Sundays And Holidays Or Late At Night. |
| 99060-CPT | Low | Out Of Office Emerg Med Serv, Service S Provided On An Emergency Basis Out Of The Office Which Disrupts Other Scheduled Office Services In Addition To Basic Service |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99060. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99060 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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