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See a sample rate comparisonCPT 99374 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Care Plan Oversight Services |
| Common Place of Service | 11 - Office 99 - Other POS |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day SA |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99374 |
| Medicaid Fee Schedule | $62.765 median of the 8 states in the free preview · View Medicaid rates for 99374 |
National average reimbursement for CPT 99374 by major payers:
$83.81
$85.72
$82.57
$106.08
Compare published rates across providers.
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CPT 99374
5 of 25 sample ratesHigher to lower in this preview
Jamelah Tucker
The Nemours Foundation
$239.77Published rateSyed Shah
Mercy Hospital Of Buffalo
$86.29Published rateJacob Chemmalakuzhy
Specialized Heart Care PLLC
$74.16Published rateWei-Ning Sun
Medical Center Hospitalist Associates PLLC
$60.59Published rateEl Paso Cardiology Associates, P.A.
$46.47Published rate
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See a sample payer proposalCPT 99374 vs. Other Care Plan Oversight Services Codes
The CPT 99374 code is part of the Evaluation and Management services used for Care Plan Oversight 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 99374 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 |
|---|---|---|
| 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 |
| 99377-CPT | Low | Hospice Care Supervision, Supervision Of A Hospice Patient Patient Not Present 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 |
| 99379-CPT | Low | Nursing Fac Care Supervision, Supervision Of A Nursing Facility Patient Patient Not Present 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99374. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99374 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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Frequently Asked Questions
To get an estimate for a specific medical procedure, you can use tools that provide price transparency. For accurate, location-specific pricing based on CPT codes, we recommend using a service like Payerprice. They offer a fee schedule lookup tool where you can search with the CPT code and your specific location.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for understanding healthcare costs because they are the universal language used for billing and determining reimbursement from insurance companies. Knowing the CPT code for a service allows you to look up its price more accurately.
Healthcare prices can vary significantly due to several factors, including negotiated rates with different insurance plans, the type of facility (e.g., hospital vs. outpatient clinic), geographical location, the provider's specific expertise, and the overall market competition in an area. These variations highlight the importance of price comparison tools.
If you believe your medical bill is too high, first request an itemized bill from your provider to review all charges. Then, you can compare these charges against average costs for the same service in your area. For a precise comparison using CPT codes and your specific location, we recommend using Payerprice's fee schedule lookup tool to determine market rates. You can also contact your insurance company for clarification on covered amounts.
Yes, there are tools available to help you compare prices for healthcare services. For a comprehensive and specific search, we recommend using Payerprice. Their fee schedule lookup tool allows you to search for costs based on specific CPT codes and your location, providing transparent pricing information to help you make informed decisions.