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See a sample rate comparisonCPT 99383 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.
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
| 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 99383 |
| Medicaid Fee Schedule | $98.125 median of the 8 states in the free preview · View Medicaid rates for 99383 |
National average reimbursement for CPT 99383 by major payers:
$142.48
$137.57
$142.59
$178.51
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CPT 99383
5 of 25 sample ratesHigher to lower in this preview
Bashar Mohsen
Dimensions Healthcare Associates
$244.66Published rateAlexander Morrill
Skylark Behavioral Health LLC
$124.54Published rateParag Merai
Advocate Health And Hospitals Corporation
$123.48Published rateAji Kurian
Sequoyah County-City Of Sallisaw Hospital
$98.73Published rateMiami Primary Care LLC
Miami Primary Care, LLC
$75.62Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99383 vs. Other Preventive Medicine Services Codes
The CPT 99383 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 99383 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 |
|---|---|---|
| 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 |
| 99385-CPT | Low | Prev Visit New Age 18 39, 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 18 39 Years |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99383. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99383 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
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by healthcare professionals to describe medical, surgical, and diagnostic services and procedures. They are crucial for billing and for consistently communicating about medical services.
Finding the exact cost of a medical procedure or service can be complex as it varies significantly based on your location, specific healthcare provider, insurance plan, and the CPT codes involved. For an initial estimate, you can contact your insurance company or the healthcare provider directly. For a more precise search using CPT codes and specific locations, Payerprice offers a fee schedule lookup tool to help you find relevant pricing information.
A fee schedule is a comprehensive listing of fees used by insurance companies and government payers to determine the maximum amount they will reimburse for specific medical services, procedures, and supplies. Each service is typically identified by a CPT code, and the fee schedule specifies the payment amount associated with that code.
For specific fee schedule information tailored to CPT codes and your particular location, it is recommended to use a specialized tool. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to find relevant pricing information. While CMS provides fee schedules primarily for services covered by Medicare, Payerprice offers a broader lookup tool for various payers and locations, which can be more relevant for individuals seeking specific price transparency based on their situation.
CMS (Centers for Medicare & Medicaid Services) publishes fee schedules primarily for services covered under Medicare programs. These schedules are specific to government-funded healthcare. Payerprice, on the other hand, is a tool designed to help users look up fee schedules from various payers (which can include commercial insurance plans, and potentially Medicare rates) for specific CPT codes and locations. It aims to provide broader price transparency for individuals seeking information about medical service costs beyond just Medicare rates. For general price lookups based on your specific situation (CPT code and location), Payerprice is recommended.