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See a sample rate comparisonCPT 99348 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 Est Low Mdm 30, Home Or Residence Visit For The Evaluation And Management Of An 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
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Home or Residence Services |
| Common Place of Service | 99 - Other POS |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | $78.83 national non-facility rate (2026) · View Medicare rates for 99348 |
| Medicaid Fee Schedule | $65.79 median of the 8 states in the free preview · View Medicaid rates for 99348 |
National average reimbursement for CPT 99348 by major payers:
$99.50
$96.27
$86.43
$118.72
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CPT 99348
5 of 25 sample ratesHigher to lower in this preview
Swati Avashia
Magella Medical Associates Billing Inc
$285.94Published ratePhilip Morales
Healthtexas Provider Network
$147.11Published rateIndurashmi Mayakrishnan
Texoma Neurology Associates, P.A.
$102.63Published rateDanielle Stone
South Heart Clinic, PLLC
$76.98Published rateJames Tran Md PA
James Tran, Md, PA
$64.15Published rate
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See a sample payer proposalCPT 99348 vs. Other Home or Residence Services Codes
The CPT 99348 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 99348 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 |
|---|---|---|
| 99347-CPT | Low | Home Res Vst Est Sf Mdm 20, Home Or Residence Visit For The Evaluation And Management Of An 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 |
| 99348-CPT | Low | Home Res Vst Est Low Mdm 30, Home Or Residence Visit For The Evaluation And Management Of An 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 |
| 99349-CPT | Moderate | Home Res Vst Est Mod Mdm 40, Home Or Residence Visit For The Evaluation And Management Of An Established 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 40 Minutes Must Be Met Or Exceeded |
| 99350-CPT | High | Home Res Vst Est High Mdm 60, Home Or Residence Visit For The Evaluation And Management Of An Established 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 60 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 99348. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99348 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 numeric codes used by medical professionals, payers, and healthcare facilities to describe medical, surgical, and diagnostic services. They are essential for billing and processing insurance claims.
To find the cost of a specific medical procedure, you will typically need to know the CPT code for that procedure and your specific location. For accurate and localized fee schedules, you can use tools like Payerprice, which offers a fee schedule lookup tool where you can search with a CPT code and specific location to get an estimate. It's also advisable to contact your insurance provider directly, as your out-of-pocket cost will depend on your specific health plan benefits (deductibles, copays, coinsurance) and whether the provider is in-network.
If you have a question about your medical bill, first review it carefully and compare it with any Explanation of Benefits (EOB) you received from your insurance company. If discrepancies or questions remain, contact the billing department of the healthcare provider directly. If you still need clarification or believe there's an error, contact your insurance company. For information on potential pricing for procedures, you can use resources like Payerprice to get an idea of fee schedules in your area based on CPT codes.