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See a sample rate comparisonCPT 99387 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 65 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 65 Years And Older
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Preventive Medicine Services |
| Common Place of Service | 11 - Office |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99387 |
| Medicaid Fee Schedule | $130.23 median of the 8 states in the free preview · View Medicaid rates for 99387 |
National average reimbursement for CPT 99387 by major payers:
$197.71
$195.26
$195.56
$238.22
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CPT 99387
5 of 25 sample ratesHigher to lower in this preview
Christine Bui
Menalam Health Services PC
$600.84Published rateJames Hurley
James M. Hurley M.D., P.A. Dba Texarkana Cardiology Associates
$203.11Published rateFrank Madla
$185.53Published rateSindura Alloju
Balance Diabetes And Endocrinology PLLC
$144.78Published rateMark Mazzare
Premium Choice Physicians
$97.59Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99387 vs. Other Preventive Medicine Services Codes
The CPT 99387 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 99387 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 |
|---|---|---|
| 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 |
| 99386-CPT | Low | Prev Visit New Age 40 64, 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 40 64 Years |
| 99387-CPT | Low | Init Pm E M New Pat 65 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 65 Years And Older |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99387. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99387 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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