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See a sample rate comparisonCPT 99091 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.
Collj Interpj Data Ea 30 D, Collection And Interpretation Of Physiologic Data Eg Ecg Blood Pressure Glucose Monitoring Digitally Stored And Or Transmitted By The Patient And Or Caregiver To The Physician Or Other Qualified Health Care Professional Qualified By Education Training Licensure Regulation When Applicable Requiring A Minimum Of 30 Minutes Of Time Each 30 Days
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Services, Procedures and Reports |
| Common Place of Service | 11 - Office 99 - Other POS |
| Common Modifiers | None 52 - Reduced Services 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99091 |
| Medicaid Fee Schedule | View Medicaid rates for 99091 |
National average reimbursement for CPT 99091 by major payers:
$69.06
$71.70
$67.78
$88.10
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CPT 99091
5 of 25 sample ratesHigher to lower in this preview
Henry Ntende
$119.15Published rateRanda Djendou
Methodist Hospital
$94.23Published rateVed Ganeshram
La Magna Health, PLLC
$76.94Published rateJoseph Quintana
Dr Ajai J Agarwal Md PA
$59.81Published rateParul Garg
Clear Lake Primary Care PLLC
$48.52Published rate
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See a sample payer proposalCPT 99091 vs. Other Special Services, Procedures and Reports Codes
The CPT 99091 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 99091 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 |
|---|---|---|
| 99001-CPT | Low | Handling Andor Conveyance Of, Handling Andor Conveyance Of Specimen For Transfer From Thepatient In Other Than A Physicians Office To A Laboratory (Distance May Be Indicated) |
| 99002-CPT | Low | Device Handling Phys Qhp, Handling Conveyance And Or Any Other Service In Connection With The Implementation Of An Order Involving Devices Eg Designing Fitting Packaging Handling Delivery Or Mailing When Devices Such As Orthotics Protectives Prosthetics Are Fabricated By An Outside Laboratory Or Shop But Which Items Have Been Designed And Are To Be Fitted And Adjusted By The Attending Physician Or Other Qualified Health Care Professional |
| 99070-CPT | Low | Special Supplies Phys Qhp, 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 Or Materials Provided |
| 99091-CPT | Low | Collj Interpj Data Ea 30 D, Collection And Interpretation Of Physiologic Data Eg Ecg Blood Pressure Glucose Monitoring Digitally Stored And Or Transmitted By The Patient And Or Caregiver To The Physician Or Other Qualified Health Care Professional Qualified By Education Training Licensure Regulation When Applicable Requiring A Minimum Of 30 Minutes Of Time Each 30 Days |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99091 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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