CPT (Current Procedural Terminology) codes are a standardized set of five-digit alphanumeric codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are essential for billing, processing claims, and communicating medical services uniformly across the healthcare system.

How can I find out the cost of a specific medical procedure?

Finding the exact cost of a medical procedure can be complex due to variables like your insurance plan, geographic location, and the specific provider. For a personalized estimate based on your specific situation, including the CPT code for the procedure and your location, it is recommended to use tools like Payerprice. They offer a fee schedule lookup tool designed to provide more precise cost information.

Where can I find fee schedules for medical services?

Fee schedules for medical services are often proprietary to different payers (insurance companies) or based on government programs like Medicare (which publishes its own fee schedules through CMS). For a general understanding or for specific procedure costs relevant to your individual situation, including a CPT code and location, resources like Payerprice's fee schedule lookup tool are highly recommended.

What is the difference between using Payerprice and CMS for healthcare pricing information?

CMS (Centers for Medicare & Medicaid Services) publishes fee schedules primarily for services covered under Medicare and Medicaid programs. While these provide a baseline, actual costs for commercially insured patients or those with different insurance plans can differ significantly. Payerprice, on the other hand, is a tool specifically designed to help users look up fee schedules with CPT codes and specific locations, offering more relevant and granular pricing information for a broader range of payers and specific patient situations beyond just Medicare/Medicaid rates.

Can I get an accurate estimate for a specific medical procedure in my local area?

Yes, getting an accurate estimate for a specific medical procedure in your local area is possible. To do so, you'll typically need the CPT code for the procedure and your specific location. Tools like Payerprice specialize in providing this kind of detailed, localized fee schedule information, allowing you to search with CPT codes and specific geographic areas to get a more precise understanding of potential costs for various payers.

CPT 99315 Fee Schedule

Last Verified: July 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.

Discharge Care Nursing Home, Physician Services For Discharge From Nursing Home. The Amount Of Time The Physician Spends Is Determined By A Persons Condition And Treatment Needs.

Key Fact	Detail
Service Type	Nursing Facility Discharge Services Nursing Facility Services
Common Place of Service	99 - Other POS None
Common Modifiers	None CG - Policy criteria applied SA
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 99315

National average reimbursement for CPT 99315 by major payers:

$94.44

$86.26

$77.24

$111.72

Preview provider-level rates for...

For billing codeCPT 99315

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	99315	$59.77	1619157492 - PRABHUGOUDA PATIL	10658223 - (TX) PRABHU B PATILMDPA	TX	Internal Medicine Physician (207R00000X)
United	99315	$63.50	1831446665 - FONDA CHAN	751667190 - (TX) NEUROLOGY CONSULTANTS OF DALLAS, P.A.	TX	Neurology Physician (2084N0400X)
United	99315	$89.51	1912143421 - BIELOSE KONWE	208536345 - (TX) PRMC HEALTHCARE GROUP INC	TX	Internal Medicine Physician (207R00000X)
United	99315	$59.77	1336408954 - JORGE BIZET SORIA	825481245 - (TX) CYPRESS COMPREHENSIVE MEDICAL SERVICES PLLC	TX	Internal Medicine Physician (207R00000X)
United	99315	$97.69	1598976763 - ERIN KOVAL	452498998 - (TX) ADULT INPATIENT MEDICAL SERVICES	TX	Internal Medicine Physician (207R00000X)
United	99315	$143.02	1619996071 - RICHARD WARD	752613493 - TEXAS HEALTH PHYSICIANS GROUP	TX	Internal Medicine Physician (207R00000X)
United	99315	$72.51	1164645347 - SHERMAN CARDIOVASCULAR CARE ASSOCIATES PA	752849373 - (TX) SHERMAN CARDIOVASCULAR CARE ASSOCIATES, P.A.	TX	Cardiovascular Disease Physician (207RC0000X)
United	99315	$205.69	1477609295 - ANDREA URBAN	42453032 - (MA) HOLLISTON PEDIATRIC GROUP, INC.	MA	Pediatrics Physician (208000000X)
United	99315	$113.93	1891130092 - BRANDY MA	300520570 - (TX) METHODIST HOSPITAL	TX	Neurology Physician (2084N0400X)
United	99315	$143.02	1770552564 - AFEEFA CHAUDHRY	752613493 - TEXAS HEALTH PHYSICIANS GROUP	TX	Internal Medicine Physician (207R00000X)
United	99315	$84.81	1316248503 - JOHN MELEK	752434817 - (TX) M.D. ON CALL, P.A.	TX	Internal Medicine Physician (207R00000X)
United	99315	$55.95	1609930809 - MICHAEL A FLORES M.D., P.A	200134074 - (TX) MICHAEL A FLORES MD PA	TX	Internal Medicine Physician (207R00000X)
United	99315	$68.19	1679724801 - HASSAAN RASHEED	871130762	TX	Internal Medicine Physician (207R00000X)
United	99315	$149.50	1487697546 - NGUYEN TRAN	810672925 - (TX) NGUYEN X TRAN ASSOCIATES	TX	Internal Medicine Physician (207R00000X)
United	99315	$102.73	1073076204 - OMER YAVUZ	742958277 - SCOTT & WHITE CLINIC	TX	Internal Medicine Physician (207R00000X)
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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Run a free sample report

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

Explore state-level rates for free

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 99315 vs. Other Nursing Facility Services Codes

The CPT 99315 code is part of the Nursing Facility Discharge Services services used for Nursing Facility 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 99315 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
99306-CPT	High	1st Nf Care High Mdm 50, Initial Nursing Facility 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 50 Minutes Must Be Met Or Exceeded
99307-CPT	Low	Medical Care, Subsequent Nursing Facility Care Per Day For The Evaluation And Management Of A Patient Which Requires At Least 2 Of These 3 Key Components: A Problem Focused Interval History; A Problem Focused Examination; Straightforward Medical Decision Making. Counseling And/Or Coordination Of Care With Other Physicians Other Qualified Health Care Professionals Or Agencies Are Provided Consistent With The Nature Of The Problem(S) And The Patients And/Or Familys
99308-CPT	Low	Sbsq Nf Care Low Mdm 20, Subsequent Nursing Facility Care Per Day For The Evaluation And Management Of A 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
99315-CPT	Low	Discharge Care Nursing Home, Physician Services For Discharge From Nursing Home. The Amount Of Time The Physician Spends Is Determined By A Persons Condition And Treatment Needs.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99315 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 99315) and we'll show you how you compare in 15 minutes or less.

Schedule a Demo