CPT 99214 Fee Schedule

Last Verified: November 2025

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.

Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Level Of Medical Decisionmaking. When Using Total Time On The Date Of The Encounter For Code Selection 30 Minutes Must Be Met Or Exceeded. (Desc Rvsd 1/1/2024)

Key Fact	Detail
Service Type	• Evaluation and Management • Office or Other Outpatient Services
Common Place of Service	• 11 - Office • 20 - Urgent Care Facility • None
Common Modifiers	• None • 25 - Significant, separately identifiable E/M service same day • 95 - Telemedicine - audio and video
Complexity Level	Moderate

National average reimbursement for CPT 99214 by major payers:

$130.37

$124.63

$119.38

$174.28

Preview provider-level rates for...

For billing codeCPT 99214

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 99214
United	99214	$89.44	1336184316 - NHANHAU NGO	330705821	CA	Family Medicine Physician (207Q00000X)
United	99214	$180.52	1528744935 - CLOUD HEALTH MEDICAL GROUP, P.A.	932013924 - (CA) CLOUD HEALTH MEDICAL GROUP PA	GA	Internal Medicine Physician (207R00000X)
United	99214	$85.00	1073551123 - SEARS MEDICAL ASSOCIATES	752519620 - (TX) SEARS MEDICAL ASSOCIATES	TX	Family Medicine Physician (207Q00000X)
United	99214	$68.70	1154565661 - BISHR AL DABAGH	844002325 - (FL) BOLD CITY DERMATOLOGY LLC	FL	MOHS-Micrographic Surgery Physician (207ND0101X)
United	99214	$126.33	1932981867 - MARIANNA CHAVEZ	993806047	CA	Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
United	99214	$376.89	1467988824 - STEPHEN HUGDAL	770465765	CA	Diagnostic Radiology Physician (2085R0202X)
United	99214	$119.23	1306467121 - BRITTNEY LOLLIS	832675429	TX	Addiction (Substance Use Disorder) Counselor (101YA0400X)
United	99214	$142.83	1457963548 - ANN ARMSTRONG	561093722 - ORTHOCAROLINA, P.A.	NC	Physical Therapist (225100000X)
United	99214	$395.73	1376957241 - CARRIE JURKIEWICZ	770465765	CA	Emergency Medicine Physician (207P00000X)
United	99214	$77.05	1326039678 - FAUZIA KHAN	264067361 - (CA) FAUZIA KHAN, M.D., INC.	CA	Internal Medicine Physician (207R00000X)
United	99214	$159.91	1003309634 - CHRISTOFER ZAPATA	461243081	FL	Family Medicine Physician (207Q00000X)
United	99214	$142.83	1609390392 - CHRISTOPHER MOORE	561093722 - ORTHOCAROLINA, P.A.	NC	Physical Therapist (225100000X)
United	99214	$70.37	1164668786 - PREMIER FAMILY MEDICINE ASSOCIATES, INC, <UNAVAIL>	954709950 - (CA) PREMIER FAMILY MEDICINE ASSOC. INC.	CA	Health Service Clinic/Center (261QH0100X)
United	99214	$142.83	1437124823 - KEVIN CASEY	561093722 - ORTHOCAROLINA, P.A.	NC	Physician Assistant (363A00000X)
United	99214	$215.35	1740547421 - MATTHEW SMITH-RASKA	131623978	CA	Neonatal-Perinatal Medicine Physician (2080N0001X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 99214 vs. Other Office or Other Outpatient Services Codes

The CPT 99214 code is part of the Evaluation and Management services used for Office or Other Outpatient Services. 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 99214 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
99211	Low	Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient, That May Not Require The Presence Of A Physician Or Other Qualified Health Care Professional. Usually, The Presenting Problem(S) Are Minimal.
99212	Low	Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Straightforward Medical Decision Making. When Using Total Time On The Date Of The Encounter For Code Selection 10 Minutes Must Be Met Or Exceeded. (Desc Rvsd 1/1/2024)
99213	Low	Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Low Level Of Medical Decision Making. When Using Total Time On The Date Of The Encounter For Code Selection 20 Minutes Must Be Met Or Exceeded. (Desc Rvsd 1/1/2024)
99214	Moderate	Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Level Of Medical Decisionmaking. When Using Total Time On The Date Of The Encounter For Code Selection 30 Minutes Must Be Met Or Exceeded. (Desc Rvsd 1/1/2024)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99214. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99214 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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