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See a sample rate comparisonCPT 99288 Fee Schedule
Last Verified: October 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.
Physician Or Other Qualified H, Physician Or Other Qualified Health Care Professional Direction Of Emergency Medical Systems (Ems) Emergency Care Advanced Life Support
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Emergency Department Services |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision SA |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99288 |
| Medicaid Fee Schedule | $53.09 median of the 7 states in the free preview · View Medicaid rates for 99288 |
National average reimbursement for CPT 99288 by major payers:
$80.11
$122.12
$62.69
$291.05
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CPT 99288
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$608.79Published rateLatania Booker
Straub Clinic & Hospital
$92.91Published rateMichelle Mora
Dartmouth-Hitchcock Clinic
$86.26Published rateDa Pediatric Rehabilitation
$55.00Published rateGowri Lakshminarayan
Sentient Sms Holdings Corporation
$34.59Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99288 vs. Other Emergency Department Services Codes
The CPT 99288 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 99288 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, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components A Problem Focused History A Problemfocused Examination And Straightforward Medical |
| 99282-CPT | Low | Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components An Expanded Problem Focused Historyan Expanded Problem Focused Examination And Medi |
| 99283-CPT | Low | Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components An Expanded Problem Focused Historyan Expanded Problem Focused Examination And Medi |
| 99288-CPT | Low | Physician Or Other Qualified H, Physician Or Other Qualified Health Care Professional Direction Of Emergency Medical Systems (Ems) Emergency Care Advanced Life Support |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99288. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99288 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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Frequently Asked Questions
Payerprice is a tool designed to help users look up healthcare fee schedules. It allows you to search for specific medical procedure costs using CPT codes and your specific location, providing more tailored pricing information.
CMS stands for the Centers for Medicare & Medicaid Services. It is a federal agency within the United States Department of Health and Human Services that administers Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). CMS publishes extensive fee schedules and pricing data primarily for governmental programs and general public reference.
To find out the specific cost of a medical procedure or service tailored to your location and the exact service you need, it's recommended to use a specialized tool like Payerprice. Payerprice offers a fee schedule lookup tool where you can search using a CPT code and your specific location to get relevant pricing information.
While CMS provides general fee schedules and pricing data, Payerprice is specifically designed to offer a user-friendly fee schedule lookup tool for individuals. It allows you to search with a specific CPT code and location for more granular and personalized cost estimates, which can be more practical for understanding potential out-of-pocket expenses compared to navigating the broader, more complex data sets provided by CMS.
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, healthcare providers, and payers to describe medical, surgical, and diagnostic services. They are essential for billing and for standardizing communication about medical procedures.
Payerprice aims to provide a comprehensive lookup tool. For specific details on its coverage of locations and the range of CPT codes available, it is best to visit the Payerprice website or utilize their search tool directly. They are designed to offer detailed fee schedule information for a wide array of services and geographical areas.