CPT 99350 Fee Schedule
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.
| 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
| 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 | $180.71 | 1598943516 - COLLINS KWARTENG | 820973412 | GA | Cardiovascular Disease Physician (207RC0000X) |
United | 99350 | $151.63 | 1770861742 - AUSTON MYERS | 742844785 - (TX) MEDCARE ASSOCIATES PA | TX | Internal Medicine Physician (207R00000X) |
United | 99350 | $255.61 | 1265420731 - JOHN ANTALIS | 581336819 - (GA) DALTON FAMILY PRACTICE, P.C. | GA | Family Medicine Physician (207Q00000X) |
United | 99350 | $203.33 | 1104017086 - H. KYLE GAY MD PC | 273100894 | GA | Family Medicine Physician (207Q00000X) |
United | 99350 | $279.85 | 1598053654 - HINA DURANI | 593140335 - BAYCARE MEDICAL GROUP INC | GA | Family Medicine Physician (207Q00000X) |
United | 99350 | $463.36 | 1790793586 - SABREENA BASU | 582030692 - EMORY UNIVERSITY | GA | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 99350 | $311.89 | 1790308484 - RACHEAL DANIELS | 831072238 - (GA) ALLCARE GA PC | GA | Family Medicine Physician (207Q00000X) |
United | 99350 | $335.45 | 1487600748 - DAVID JACOBSON | 581824696 - (GA) DIABETES & ENDOCRINOLOGY ASSOCIATES, P.C | GA | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 99350 | $393.86 | 1093206518 - MINDY GUO | 204700877 | GA | Family Medicine Physician (207Q00000X) |
United | 99350 | $164.35 | 1023219862 - AFUA AGYARKO | 844513804 - (TX) FIT WELL MD PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99350 | $164.91 | 1801859327 - KELLY CARSON | 593787174 | GA | Gastroenterology Physician (207RG0100X) |
United | 99350 | $273.70 | 1285624148 - SRINIVASA AYINALA | 582238919 - (GA) ATLANTA GASTROENTEROLOGY ASSOCIATES | GA | Gastroenterology Physician (207RG0100X) |
United | 99350 | $146.08 | 1235212580 - VEENA SURAPANENI | 742943800 - (TX) VEENA SURAPANENI PA | TX | Internal Medicine Physician (207R00000X) |
United | 99350 | $204.52 | 1164459814 - BRUCE HARMAN | 611735752 - (TX) PREMIER PHC PHYSICIAN GROUP INC. | TX | Internal Medicine Physician (207R00000X) |
United | 99350 | $204.52 | 1902893365 - VICTOR RON | 752932354 - (TX) LATINO MEDICAL AND WEIGHT LOSS CENTER PROFESSIONAL ASSOCIATION | 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 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 | 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 | 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 | 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 | 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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