CPT 99380 Fee Schedule

Last Verified: July 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	Care Plan Oversight Services Evaluation and Management
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

National average reimbursement for CPT 99380 by major payers:

$126.94

$128.09

$115.37

$157.75

Preview provider-level rates for...

For billing codeCPT 99380

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	99380	$621.28	1689872301 - CHRIS CARPENTER	943281657	MA	Pediatrics Physician (208000000X)
United	99380	$233.47	1992965826 - KATHLEEN LEVIN	43283986 - (MA) HEALTHCARE SOUTH, PC	MA	Pediatrics Physician (208000000X)
United	99380	$106.16	1679718654 - STACEY DIPALMA	201543752	MA	Pediatrics Physician (208000000X)
United	99380	$305.64	1083605984 - JOHN PATRICK CO	42697983 - MASS GENERAL BRIGHAM INCORPORATED	MA	Pediatrics Physician (208000000X)
United	99380	$106.13	1306947668 - ELLEN SIGMAN	1306947668 - (MA) ELLEN SIGMAN	MA	Pediatrics Physician (208000000X)
United	99380	$114.30	1548379696 - JOSE LIM	861069305 - (TX) JOSE AUDIE E LIM MDPA	TX	Internal Medicine Physician (207R00000X)
United	99380	$199.63	1588898472 - CHRISTINE MARRESE	42888373 - BAYSTATE MEDICAL PRACTICES INC	MA	Pediatrics Physician (208000000X)
United	99380	$121.45	1174572077 - SHAHRAM SANI	474843039 - (TX) PERIOPERATIVE AND TRANSITIONAL	TX	Internal Medicine Physician (207R00000X)
United	99380	$199.63	1063869386 - KATHERINE HARER	42888373 - BAYSTATE MEDICAL PRACTICES INC	MA	Pediatrics Physician (208000000X)
United	99380	$102.40	1467074542 - TIMOTHY TRAN	820540404 - (TX) WESTLAKE DERMATOLOGY, PA	TX	Internal Medicine Physician (207R00000X)
United	99380	$251.00	1841559911 - THOMAS RODRIGUEZ	852744492 - (WI) ASCENSION WISCONSIN EMERUS MENOMONEE FALLS LLC	TX	Internal Medicine Physician (207R00000X)
United	99380	$93.09	1124105937 - VIJAYSHEKAR ELATI	800711887 - (TX) HOUSTON INTERNAL MEDICINE ASSOCIATES, P.A.	TX	Internal Medicine Physician (207R00000X)
United	99380	$102.76	1346295532 - MARIA KINTANAR	651255384	TX	Internal Medicine Physician (207R00000X)
United	99380	$271.47	1689664815 - KARA RYAN	43066227 - (MA) HYDE PARK PEDIATRICS PC	MA	Pediatrics Physician (208000000X)
United	99380	$122.50	1255376679 - RODOLFO SOTOLONGO	760591133 - (TX) SOUTHEAST TEXAS CARDIOLOGY ASSOCIATES II LLP	TX	Cardiovascular Disease Physician (207RC0000X)
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 99380 vs. Other Evaluation and Management Codes

The CPT 99380 code is part of the Care Plan Oversight Services services used for Evaluation and Management. 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
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
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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