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 | Low |
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 | $113.22 | 1154501799 - SHINTA JONG | 991855405 - SEEN MEDICAL GROUP OF TX PA | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $44.45 | 1316172067 - RABAB MOHSIN | 813739568 - (TX) RABAB MOHSIN MD PLLC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99347 | $83.22 | 1235490426 - TIGIST MEHARI | 860320447 - SUMMIT HEALTHCARE ASSOCIATION | TX | Neurology Physician (2084N0400X) |
United | 99347 | $50.02 | 1841386125 - FRANK MAHZARI | 824094685 - (TX) ADVANCED SURGEONS PHYSICIANS NETWORK INC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $68.08 | 1710271432 - TRAVIS LEHMAN | 756047638 - (TX) WILBARGER GENERAL HOSPITAL EMPLOYEE BENEFIT PLAN | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $43.66 | 1336172105 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
United | 99347 | $42.11 | 1003288879 - ZIMA MEDICAL GROUP, PLLC | 832213611 | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $44.45 | 1073550919 - DELTA MEDICAL PA, DELTA MEDICAL CLINIC | 204188816 - (TX) DELTA MEDICAL, PA | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $77.75 | 1669913851 - FELICIA AUSTIN | 521372665 - (MD) NORTHWEST HOSPITAL CENTER INC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $49.20 | 1871570705 - MICHAEL ROTENBERG | 760386549 | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99347 | $131.78 | 1275614372 - CAMILO JIMENEZ | 760273984 | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $56.00 | 1265810089 - AUSTIN LEWIS | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $40.84 | 1629139712 - CHARLOTTE APPLETON | 272022354 - (TX) TRUMEN PHYSICIANS AND ASSOCIATES PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $55.86 | 1518075357 - SUZANNE LASEK-NESSELQUIST | 741322777 - (TX) WEST UNIVERSITY INTERNAL MEDICINE, PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99347 | $69.76 | 1891756672 - MICHAEL PALM | 741586031 | TX | Neurology Physician (2084N0400X) |
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 |
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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-CPT | 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-CPT | 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-CPT | 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-CPT | 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.
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