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 99367 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.
Team Conf W O Pat By Phys, Medical Team Conference With Interdisciplinary Team Of Health Care Professionals Patient And Or Family Not Present 30 Minutes Or More Participation By Physician
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Case Management Services |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | SA 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99367 |
| Medicaid Fee Schedule | $34.96 median of the 7 states in the free preview · View Medicaid rates for 99367 |
National average reimbursement for CPT 99367 by major payers:
$82.38
$68.41
$63.17
$94.49
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 99367.
CPT 99367
5 of 25 sample ratesHigher to lower in this preview
Aderonke Salau-Okeleji
Texas Health Physicians Group
$187.78Published rateBilly Jones
Scott & White Clinic
$95.87Published rateKhalid Shafiq
Khalid Shafiq Md PA
$69.72Published rateAriana Klein
Su Clinica Familiar
$52.29Published rateScott Krall
Amistad Community Health Center Incorporated
$45.56Published 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 99367 vs. Other Case Management Services Codes
The CPT 99367 code is part of the Evaluation and Management services used for Case Management 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 99367 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 |
|---|---|---|
| 99367-CPT | Low | Team Conf W O Pat By Phys, Medical Team Conference With Interdisciplinary Team Of Health Care Professionals Patient And Or Family Not Present 30 Minutes Or More Participation By Physician |
| 99368-CPT | Low | Team Conf W O Pat By Hc Pro, Medical Team Conference With Interdisciplinary Team Of Health Care Professionals Patient And Or Family Not Present 30 Minutes Or More Participation By Nonphysician Qualified Health Care Professional |
| 99374-CPT | Low | Home Health Care Supervision, Supervision Of A Patient Under Care Of Home Health Agency Patient Not Present In Home Domiciliary Or Equivalent Environment Eg Alzheimer S Facility Requiring Complex And Multidisciplinary Care Modalities Involving Regular Development And Or Revision Of Care Plans By That Individual Review Of Subsequent Reports Of Patient Status Review Of Related Laboratory And Other Studies Communication Including Telephone Calls For Purposes Of Assessment Or Care Decisions With Health Care Professional S Family Member S Surrogate Decision Maker S Eg Legal Guardian And Or Key Caregiver S Involved In Patient S Care Integration Of New Information Into The Medical Treatment Plan And Or Adjustment Of Medical Therapy Within A Calendar Month 15 29 Minutes |
| 99375-CPT | Low | Home Health Care Supervision, Supervision Of A Patient Under Care Of Home Health Agency Patient Not Present In Home Domiciliary Or Equivalent Environment Eg Alzheimer S Facility Requiring Complex And Multidisciplinary Care Modalities Involving Regular Development And Or Revision Of Care Plans By That Individual Review Of Subsequent Reports Of Patient Status Review Of Related Laboratory And Other Studies Communication Including Telephone Calls For Purposes Of Assessment Or Care Decisions With Health Care Professional S Family Member S Surrogate Decision Maker S Eg Legal Guardian And Or Key Caregiver S Involved In Patient S Care Integration Of New Information Into The Medical Treatment Plan And Or Adjustment Of Medical Therapy Within A Calendar Month 30 Minutes Or More |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99367. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99367 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 99367) and we'll show you how you compare in 15 minutes or less.