CPT 99350 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

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.(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	High

National average reimbursement for CPT 99350 by major payers:

$219.44

$204.56

$187.83

$265.69

Preview provider-level rates for...

For billing codeCPT 99350

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 99350
United	99350	$335.45	1578556619 - WENDELL SMITH	262824776 - (GA) PIEDMONT PROFESSIONAL SERVICES LLC	GA	Family Medicine Physician (207Q00000X)
United	99350	$146.08	1295354934 - AD PRECISION MEDICAL PLLC	850531864 - (TX) AD PRECISION MEDICAL PLLC	TX	Internal Medicine Physician (207R00000X)
United	99350	$237.21	1700812633 - GARY STERN	455292251 - (GA) WAYNE SJC MEDICAL GROUP LLC	GA	Cardiovascular Disease Physician (207RC0000X)
United	99350	$280.97	1679937577 - REBECCA SELLERS	472221436	GA	Family Medicine Physician (207Q00000X)
United	99350	$142.91	1477500122 - SWATI GAUR	204965119 - (GA) SENIOR CARE OFFICE LLC	GA	Geriatric Medicine (Internal Medicine) Physician (207RG0300X)
United	99350	$173.47	1902888357 - ELVIN IRVIN	630705119 - (AL) POARCH BAND OF CREEK INDIANS	GA	Family Medicine Physician (207Q00000X)
United	99350	$127.83	1134278187 - THOMAS KARISNY MD PC	582631866 - (GA) THOMAS KARISNY MD PC	GA	Family Medicine Physician (207Q00000X)
United	99350	$199.44	1043238470 - AVERY STRICKLAND	10594994 - COOPERATIVE HEALTHCARE SERVICES INC	GA	Cardiovascular Disease Physician (207RC0000X)
United	99350	$335.45	1780188276 - STEPHEN SCOTT	581351195 - (GA) FAMILY PRACTICE CENTER, P.C.	GA	Adult Medicine Physician (207QA0505X)
United	99350	$255.44	1881069227 - ST FRANCIS PHYSICIAN PRACTICES LLC, ST. FRANCIS CENTER FOR DIGESTIVE DISORDERS	475419443	GA	Gastroenterology Physician (207RG0100X)
United	99350	$164.22	1982794772 - MARC HARRIGAN	832538251 - (GA) POST ACUTE CARE LEADERS LLC	GA	Family Medicine Physician (207Q00000X)
United	99350	$228.99	1568924447 - NYSSA ADAMS	741613878 - (TX) BAYLOR COLLEGE OF MEDICINE	TX	Internal Medicine Physician (207R00000X)
United	99350	$385.76	1437155074 - MARC THAMES	581537752 - EMORY UNIVERSITY	GA	Cardiovascular Disease Physician (207RC0000X)
United	99350	$463.36	1790793586 - SABREENA BASU	582030692 - EMORY UNIVERSITY	GA	Endocrinology, Diabetes & Metabolism Physician (207RE0101X)
United	99350	$379.23	1184044679 - HAFSA BHATTI	840438224 - PORTERCARE ADVENTIST HEALTH SYSTEM	GA	Family Medicine Physician (207Q00000X)
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 99350 vs. Other Home or Residence Services Codes

The CPT 99350 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 99350 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)
99350-CPT	High	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.(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 99350. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99350 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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