CPT 99284 Fee Schedule

Last Verified: January 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.

Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Level Of Medical Decision Making (Desc Rvsd 1/1/23)

Key Fact	Detail
Service Type	• Evaluation and Management • Emergency Department Services
Common Place of Service	• 23 - Emergency Room • None • 22 - On Campus Outpatient Hospital
Common Modifiers	• None • 25 - Significant, separately identifiable E/M service same day • U7
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 99284

National average reimbursement for CPT 99284 by major payers:

$154.01

$118.58

$138.72

$182.31

Preview provider-level rates for...

For billing codeCPT 99284

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 99284
United	99284	$142.57	1174882625 - WINTHROP GERIATRIC MEDICINE ASSOCIATES PC	113158967	NY	Geriatric Medicine (Internal Medicine) Physician (207RG0300X)
United	99284	$322.91	1891094058 - SAMANTHA STOLL	43080484 - (MA) MASS GENERAL BRIGHAM INCORPORATED	MA	Emergency Medicine Physician (207P00000X)
United	99284	$197.80	1841403730 - KIMBERLEY JONES	472660438 - (FL) MD4ER LLC	FL	Emergency Medicine Physician (207P00000X)
United	99284	$152.86	1245675552 - MICHAEL TURKEN	943281662	CA	Internal Medicine Physician (207R00000X)
United	99284	$287.79	1639952930 - MCKENZIE HANSEN	931224010 - PRAXIS HEALTH, P.C.	OR	Family Medicine Physician (207Q00000X)
United	99284	$279.54	1295099182 - MICHAEL BURSEY	580705892 - AU MEDICAL ASSOCIATES INC	GA	Emergency Medicine Physician (207P00000X)
United	99284	$273.57	1700843919 - MARIARITA PETRILLO-BOLANOS	272777455	MA	Emergency Medicine Physician (207P00000X)
United	99284	$367.64	1932621778 - CALLEE HEYWOOD	111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER	NY	Emergency Medicine Physician (207P00000X)
United	99284	$166.75	1740262252 - JON WINTHER	351747218 - INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC	IN	Emergency Medicine Physician (207P00000X)
United	99284	$279.54	1891956520 - MICHAEL FERGUSON	474418776 - (GA) AU MEDICAL ASSOCIATES EMERGENCY MEDICINE BILLING SERVICES LLC	GA	Emergency Medicine Physician (207P00000X)
United	99284	$230.88	1528647484 - MATTHEW REEVES	561398929	NC	Emergency Medicine Physician (207P00000X)
United	99284	$256.89	1518321108 - YAMAL TAHA	582030692 - EMORY UNIVERSITY	GA	Emergency Medicine Physician (207P00000X)
United	99284	$162.00	1013271865 - SCOTT MILINOVICH	346004382	OH	Emergency Medicine Physician (207P00000X)
United	99284	$86.59	1013304302 - CHRISTINA ENG	132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION	NY	Emergency Medicine Physician (207P00000X)
United	99284	$256.89	1972922474 - MONIQUE SMITH	581537752 - EMORY UNIVERSITY	GA	Emergency Medicine Physician (207P00000X)
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 99284 vs. Other Emergency Department Services Codes

The CPT 99284 code is part of the Evaluation and Management services used for Emergency Department 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 99284 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
99281-CPT	Low	Emergency Department Visit For The Evaluation And Management Of A Patient That May Not Require The Presence Of A Physician Or Other Qualified Health Care Professional (Desc Rvsd 1/1/23)
99282-CPT	Low	Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And/Or Examination And Straightforward Medical Decision Making (Desc Rvsd 1/1/23)
99283-CPT	Low	Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And/Or Examination And Low Level Of Medical Decision Making (Desc Rvsd 1/1/23)
99284-CPT	Moderate	Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Level Of Medical Decision Making (Desc Rvsd 1/1/23)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99284. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99284 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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