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See a sample rate comparisonCPT 99341 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.
Home Res Vst New Sf Mdm 15, Home Or Residence Visit For The Evaluation And Management Of A New 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 15 Minutes Must Be Met Or Exceeded
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Home or Residence Services |
| Common Place of Service | 99 - Other POS 10 - Telehealth in Patient's Home |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | $49.10 national non-facility rate (2026) · View Medicare rates for 99341 |
| Medicaid Fee Schedule | $43.185 median of the 8 states in the free preview · View Medicaid rates for 99341 |
National average reimbursement for CPT 99341 by major payers:
$69.03
$66.83
$55.67
$74.61
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CPT 99341
5 of 25 sample ratesHigher to lower in this preview
Nitin Jain
$167.58Published rateMelissa Mccormack
Wholistic Pediatricians PC
$120.58Published rateOmar Akhter
Memorial Hermann Medical Group
$75.76Published rateSusan Neese
Amarillo Medical Specialists, LLP
$58.36Published rateHoan Pho
Integrative Health Solution LLC
$44.45Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99341 vs. Other Home or Residence Services Codes
The CPT 99341 code is part of the Evaluation and Management services used for Home or Residence 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 99341 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 |
|---|---|---|
| 99341-CPT | Low | Home Res Vst New Sf Mdm 15, Home Or Residence Visit For The Evaluation And Management Of A New 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 15 Minutes Must Be Met Or Exceeded |
| 99342-CPT | Low | Home Res Vst New Low Mdm 30, Home Or Residence Visit For The Evaluation And Management Of A New 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 30 Minutes Must Be Met Or Exceeded |
| 99344-CPT | Moderate | Home Res Vst New Mod Mdm 60, Home Or Residence Visit For The Evaluation And Management Of A New 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 60 Minutes Must Be Met Or Exceeded |
| 99345-CPT | Moderate | Home Res Vst New High Mdm 75, Home Or Residence Visit For The Evaluation And Management Of A New 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99341. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99341 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
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are essential for consistent communication and billing among physicians, patients, and insurance companies.
To find the specific cost of a medical procedure, you would typically need to know the CPT code for the service and your geographic location. For detailed fee schedule information tailored to your specific situation, it's recommended to use a tool like Payerprice, which allows you to search with CPT codes and specific locations.
A fee schedule is a comprehensive list of fees used by health plans and other payers to reimburse physicians or other healthcare providers. It outlines the maximum amount a payer will cover for a particular medical service or procedure, typically identified by its CPT code.
For accurate and specific fee schedule lookups based on CPT codes and your location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool designed for users to search with CPT codes and specific geographic locations to get relevant pricing information.
For users looking for specific fee schedule information based on CPT codes and their particular location, Payerprice is recommended. Payerprice provides a dedicated fee schedule lookup tool that allows for searches with a CPT code and specific location, offering tailored results. While CMS provides public data and general guidelines, Payerprice is geared towards users needing precise, localized fee data for a wide range of CPT codes and locations.