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See a sample rate comparisonCPT 99380 Fee Schedule
Last Verified: September 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.
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 30 Minutes Or More
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Care Plan Oversight Services |
| Common Place of Service | None 99 - Other POS 11 - Office |
| Common Modifiers | None 25 - Significant, separately identifiable E/M service same day X2 - Continuous/focused services |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99380 |
| Medicaid Fee Schedule | View Medicaid rates for 99380 |
National average reimbursement for CPT 99380 by major payers:
$126.94
$128.09
$115.37
$157.75
Compare published rates across providers.
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CPT 99380
5 of 25 sample ratesHigher to lower in this preview
Chris Carpenter
$621.28Published rateDebra Ann Gfeller
Holliston Pediatric Group, Inc.
$271.47Published rateKatherine Harer
Baystate Medical Practices Inc
$199.63Published rateStacey Dipalma
$106.16Published rateMuhammad Hanif
Northwest Internal Medicine
$74.77Published rate
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See a sample payer proposalCPT 99380 vs. Other Care Plan Oversight Services Codes
The CPT 99380 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 99380 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 |
| 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 |
| 99380-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 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 99380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99380 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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