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See a sample rate comparisonCPT 99239 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.
Hospital Discharge Day Managem, Hospital Discharge Day Management More Than 30 Minutes(This Code Is To Be Utilized By The Physicianto Report All Services Provided To A Patient On The Date Of Discharge If
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Hospital Inpatient and Observation Care Services |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 51 - Inpatient Psychiatric Facility |
| Common Modifiers | None GC - Service performed by resident under supervision FS - Split/shared E/M visit |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99239 |
| Medicaid Fee Schedule | View Medicaid rates for 99239 |
National average reimbursement for CPT 99239 by major payers:
$138.27
$123.70
$120.28
$166.94
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CPT 99239
5 of 25 sample ratesHigher to lower in this preview
Anna Voeller
Allina Health System
$327.70Published rateSusan Anderson
Dupage Psychiatric Care PLLC
$156.25Published rateDeep Buch
Piyush C Buch Mdpc
$120.62Published rateMartin Repetto
Coles County Mental Health Association Inc
$114.87Published rateKalyani Gavini
Southern Illinois Healthcare Foundation Inc
$97.62Published rate
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See a sample payer proposalCPT 99239 vs. Other Hospital Inpatient and Observation Care Services Codes
The CPT 99239 code is part of the Evaluation and Management services used for Hospital Inpatient and Observation Care 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 99239 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 |
|---|---|---|
| 99221-CPT | Low | 1st Hosp Ip Obs Sf Low 40, Initial Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Straightforward Or Low Level Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 40 Minutes Must Be Met Or Exceeded |
| 99222-CPT | Moderate | 1st Hosp Ip Obs Moderate 55, Initial Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 55 Minutes Must Be Met Or Exceeded |
| 99223-CPT | High | 1st Hosp Ip Obs High 75, Initial Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And High Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 75 Minutes Must Be Met Or Exceeded |
| 99239-CPT | Low | Hospital Discharge Day Managem, Hospital Discharge Day Management More Than 30 Minutes(This Code Is To Be Utilized By The Physicianto Report All Services Provided To A Patient On The Date Of Discharge If |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99239. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99239 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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