CPT 99347 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 POS |
| Common Modifiers | • None • 25 - Significant, separately identifiable E/M service same day • CG - Policy criteria applied |
| Complexity Level | Moderate |
National average reimbursement for CPT 99347 by major payers:
$64.61
$63.31
$54.37
$74.89
| 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 99347 | ||||||
United | 99347 | $63.18 | 1518030212 - GLENDA READ | 760314833 - (TX) HUNTSVILLE PEDIATRIC & ADULT MED | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $44.70 | 1649703513 - ETHAN LOPEZ | 742269739 - (TX) COMMUNITY HEALTH DEVELOPMENT INC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $113.22 | 1154501799 - SHINTA JONG | 991855405 - SEEN MEDICAL GROUP OF TX PA | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $47.47 | 1790133809 - NEHA PATEL | 901017049 - (TX) VOHRA POST ACUTE CARE PHYSICIANS OF TEXAS PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $158.00 | 1255394987 - AMIT KHERA | 43466314 - MASS GENERAL BRIGHAM INCORPORATED | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99347 | $58.95 | 1952510729 - RACHID MACWAR | 275252545 - (GA) UPSON SURGICAL ASSOCIATES LLC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99347 | $131.78 | 1306971387 - SUSAN GILCHRIST | 760273984 | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99347 | $113.22 | 1710008966 - OLIVER GHALAMBOR | 811123403 - (TX) NOBILITY MEDICAL PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $47.24 | 1801866249 - RAFAEL RODRIGUEZ | 742891661 - (TX) RAFAEL A RODRIGUEZ MD PA | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $39.09 | 1053774844 - USMAN JILANI | 993178906 | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $54.59 | 1003133315 - ANAND PATEL | 20701782 - ATLANTICARE PHYSICIAN GROUP PA | TX | Neurology Physician (2084N0400X) |
United | 99347 | $106.41 | 1740402874 - DAVID LEE | 752613493 - TEXAS HEALTH PHYSICIANS GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $47.47 | 1598886954 - BRIAN ANDERSON | 273396768 - (TX) ELITE PATIENT CARE, PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $179.63 | 1851569891 - VANESSA BUOT | 752613493 - TEXAS HEALTH PHYSICIANS GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $113.22 | 1205074135 - JENSON ABRAHAM | 884169151 - (TX) FULL LIFE PRIMARY CARE PLLC | 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.
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.
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 99347 vs. Other Home or Residence Services Codes
The CPT 99347 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 99347 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 |
|---|---|---|
| 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) |
| 99347 | Low | Home Or Residence Visit For The Evaluation And Management Of A Established 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 20 Minutes Must Be Met Or Exceeded(Desc Rvsd 1/1/23) |
| 99348 | Low | Home Or Residence Visit For The Evaluation And Management Of A Established 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) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99347. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99347 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 99347) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.