Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 99349 Fee Schedule
Last Verified: September 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 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
| 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 95 - Telemedicine - audio and video |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 99349 |
| Medicaid Fee Schedule | View Medicaid rates for 99349 |
National average reimbursement for CPT 99349 by major payers:
$154.09
$146.98
$133.52
$187.04
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 99349.
CPT 99349
5 of 25 sample ratesHigher to lower in this preview
Ericka Walker Williams
$323.85Published rateAnand Patel
Sentara Medical Group
$196.41Published rateAmit Bhardwaj
Saeed Md, PLLC
$147.86Published rateEmily Fisher
Community Health Centers Of South Central Texas Inc
$127.75Published rateSobia Yaqub PLLC, Transformations With Dr. Y
Sobia Yaqub PLLC
$104.80Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 99349 vs. Other Home or Residence Services Codes
The CPT 99349 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 99349 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 99349. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99349 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 99349) and we'll show you how you compare in 15 minutes or less.