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See a sample rate comparisonCPT 99382 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.
Init Pm E M New Pat 1 4 Yrs, Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling Anticipatory Guidance Risk Factor Reduction Interventions And The Ordering Of Laboratory Diagnostic Procedures New Patient Early Childhood Age 1 Through 4 Years
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Preventive Medicine Services |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99382 |
| Medicaid Fee Schedule | $94.20 median of the 8 states in the free preview · View Medicaid rates for 99382 |
National average reimbursement for CPT 99382 by major payers:
$144.66
$137.56
$139.62
$173.10
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CPT 99382
5 of 25 sample ratesHigher to lower in this preview
P. Daniel Le Grange
$546.70Published rateCyril Appiagyei
Northwestern Memorial Healthcare
$206.60Published rateRajavi Parikh
University Medical Service Association Inc
$152.67Published rateHeart & Rhythm Associates, PLLC
Heart And Rhythm Associates, PLLC
$118.72Published rateLunie Madhere
South Florida Cardiology Associates Dba Elite Health
$68.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99382 vs. Other Preventive Medicine Services Codes
The CPT 99382 code is part of the Evaluation and Management services used for Preventive Medicine 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 99382 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 |
|---|---|---|
| 99381-CPT | Low | Init Pm E M New Pat Infant, Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling Anticipatory Guidance Risk Factor Reduction Interventions And The Ordering Of Laboratory Diagnostic Procedures New Patient Infant Age Younger Than 1 Year |
| 99382-CPT | Low | Init Pm E M New Pat 1 4 Yrs, Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling Anticipatory Guidance Risk Factor Reduction Interventions And The Ordering Of Laboratory Diagnostic Procedures New Patient Early Childhood Age 1 Through 4 Years |
| 99383-CPT | Low | Prev Visit New Age 5 11, Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling Anticipatory Guidance Risk Factor Reduction Interventions And The Ordering Of Laboratory Diagnostic Procedures New Patient Late Childhood Age 5 Through 11 Years |
| 99384-CPT | Low | Prev Visit New Age 12 17, Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling Anticipatory Guidance Risk Factor Reduction Interventions And The Ordering Of Laboratory Diagnostic Procedures New Patient Adolescent Age 12 Through 17 Years |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99382. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99382 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
The cost of medical procedures can vary significantly based on the healthcare provider, location, and your insurance coverage. To get an estimate tailored to your specific situation, you can contact your healthcare provider directly for a quote, speak with your insurance company about your benefits and potential out-of-pocket costs, or use tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search for costs using a CPT code and your specific location to understand potential pricing.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services provided to patients. They are crucial for accurate medical billing, processing by insurance companies, and for looking up specific service prices. When searching for cost information, knowing the CPT code for your procedure allows for a more precise estimate using tools like Payerprice.
Insurance companies determine payment based on various factors, including their negotiated fee schedules with in-network providers, what they deem 'usual, customary, and reasonable' (UCR) for a service in a particular geographic area, and the specifics of your individual insurance plan (e.g., deductible, copay, coinsurance, and whether the provider is in-network or out-of-network). These factors collectively influence your out-of-pocket costs.
For detailed information on fee schedules and expected costs for specific medical procedures based on CPT codes and your location, you should use Payerprice. Payerprice provides a dedicated fee schedule lookup tool that allows you to input a CPT code and specific location to retrieve relevant pricing information. This helps you anticipate costs and make informed decisions based on your unique situation.
If you receive an unexpected or high medical bill, first, review it carefully for any errors or unfamiliar charges. Then, contact your healthcare provider's billing department to ask for an itemized bill and clarification. Simultaneously, contact your insurance company to understand how the claim was processed and what your plan covers. You may also be able to negotiate the bill directly with the provider or explore payment plans. For future reference or to compare prices for services, remember you can use Payerprice to look up typical costs for specific CPT codes in your area.