CPT 99349 Fee Schedule

Last Verified: January 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 Or Residence Visit For The Evaluation And Management Of A 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 For Code Selection 40 Minutes Must Be Met Or Exceeded (Desc Rvsd 1/1/23)

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

National average reimbursement for CPT 99349 by major payers:

$154.09

$146.98

$133.52

$187.04

Preview provider-level rates for...

For billing codeCPT 99349

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 99349
United	99349	$153.30	1396820528 - SUSAN NEESE	752562354 - (TX) AMARILLO MEDICAL SPECIALISTS, LLP	TX	Internal Medicine Physician (207R00000X)
United	99349	$141.57	1356515845 - MANAVJOT SIDHU	814670687 - (WA) SHC MEDICAL CENTER TOPPENISH	TX	Cardiovascular Disease Physician (207RC0000X)
United	99349	$147.86	1174882880 - AMIT BHARDWAJ	463457611 - (TX) SAEED MD, PLLC	TX	Internal Medicine Physician (207R00000X)
United	99349	$129.25	1720584691 - DALLAS CARDIOLOGY PLLC	824400223 - (TX) DALLAS CARDIOLOGY PLLC	TX	Cardiovascular Disease Physician (207RC0000X)
United	99349	$104.80	1962409383 - RICARDO GARZA	473144494 - (TX) RICARDO A GARZA MD PLLC	TX	Cardiovascular Disease Physician (207RC0000X)
United	99349	$105.50	1063086387 - HASAN YAQUB	363637465 - (IL) HOOPESTON COMMUNITY MEMORIAL HOSPITAL	TX	Internal Medicine Physician (207R00000X)
United	99349	$323.85	1285885228 - ERICKA WALKER WILLIAMS	756002868	TX	Internal Medicine Physician (207R00000X)
United	99349	$145.69	1679860290 - KINJAL DESAI	270381199	TX	Neurology Physician (2084N0400X)
United	99349	$196.41	1003133315 - ANAND PATEL	541217184 - SENTARA MEDICAL GROUP	TX	Neurology Physician (2084N0400X)
United	99349	$130.49	1215682067 - HEART CENTER OF CYPRESS, PLLC, HEART CENTER OF CYPRESS	880620095 - (TX) HEART CENTER OF CYPRESS PLLC	TX	Cardiovascular Disease Physician (207RC0000X)
United	99349	$122.63	1720078181 - MICHELE SARTORI	760298237 - MICHELE P. SARTORI, M.D.	TX	Cardiovascular Disease Physician (207RC0000X)
United	99349	$127.75	1467778902 - EMILY FISHER	741548089 - COMMUNITY HEALTH CENTERS OF SOUTH CENTRAL TEXAS INC	TX	Internal Medicine Physician (207R00000X)
United	99349	$143.30	1225120801 - SRI NAVEEN SURAPANENI	752005254 - TEXAS DIGESTIVE DISEASE CONSULTANTS	TX	Internal Medicine Physician (207R00000X)
United	99349	$180.13	1710948955 - RICHARD LAWLIS	742958277 - SCOTT & WHITE CLINIC	TX	Internal Medicine Physician (207R00000X)
United	99349	$216.16	1912168279 - BILL COVINGTON	742958277 - SCOTT & WHITE CLINIC	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

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CPT 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
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)
99349-CPT	Moderate	Home Or Residence Visit For The Evaluation And Management Of A 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 For Code Selection 40 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 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.

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