CPT 99344 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Evaluation and Management • Home or Residence Services |
| Common Place of Service | • None • 99 - Other Place of Service • 10 - Telehealth Provided in Patient’s Home |
| Common Modifiers | • None • 95 - Synchronous telemedicine service via real-time audio and video telecommunications • 25 - Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service |
| Complexity Level | Moderate |
National average reimbursement for CPT 99344 by major payers:
$202.63
$145.93
$178.61
$240.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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CPT 99344 vs. Other Home or Residence Services Codes
The CPT 99344 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 99344 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 | Low | 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. (Desc Rvsd 1/1/23) |
| 99342 | Low | 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. (Desc Rvsd 1/1/23) |
| 99344 | Moderate | 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. (Desc Rvsd 1/1/23) |
| 99345 | Moderate | Home Or Residence Visit For The Evaluation And Management Of A New Patient Which Requires A Medically Appropriate History And/Or Examination And Highlevel Of Medical Decision Making. When Using Total Time On The Date Of The Encounter For Code Selection 75 Minutes Must Be Met Or Exceeded. (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 99344. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99344 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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