CPT 99071 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 | • Medicine Services and Procedures • Special Services, Procedures and Reports |
| Common Place of Service | • 11 - Office • 50 - Federally Qualified Health Center • 10 - Telehealth in Patient's Home |
| Common Modifiers | • None • GT - Via interactive audio and video telecommunication systems • SA |
| Complexity Level | Moderate |
National average reimbursement for CPT 99071 by major payers:
$45.22
$28.77
$9.70
$159.15
| 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 CPT 99071 | ||||||
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CPT 99071 vs. Other Special Services, Procedures and Reports Codes
The CPT 99071 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 99071 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 |
|---|---|---|
| 99070 | Low | Supplies And Materials (Except Spectacles) Provided By The Physician Or Other Qualified Health Care Professional Over And Above Those Usually Included With The Office Visit Or Other Services Rendered (List Drugs Trays Supplies Ormaterials Provided) (Revised 01/01/13) |
| 99071 | Low | Educational Supplies Such As Books Tapes And Pamphlets For The Patients Education At Cost To Physician Or Other Qualified Health Care Professional (Revised 01/01/13) |
| 99072 | Low | Additional Supplies, Materials, And Clinical Staff Time Over And Above Those Usually Included In An Office Visit Or Other Non-Facility Service(S), When Performed During A Public Health Emergency As Defined By Law, Due To Respiratory-Transmitted Infectious Disease. |
| 99080 | Low | Special Reports Such As Insurance Forms, More Than The Information Conveyed In The Usual Medical Communications Or Standard Reporting Form |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99071. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99071 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
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