CPT 99392 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Evaluation and Management • Preventive Medicine Services |
| Common Place of Service | • 11 - Office • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • 25 - Significant, separately identifiable E/M service same day • EP - Residential facility to Physician's office |
| Complexity Level | Low |
National average reimbursement for CPT 99392 by major payers:
$130.16
$122.98
$124.84
$159.34
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 99392 | ||||||
United | 99392 | $63.22 | 1558489732 - COMPREHENSIVE HEART CARE | 201221591 - (TX) COMPREHENSIVE HEART CARE, P.A. | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99392 | $63.22 | 1699760934 - JENNIFER WALLACE | 680518000 - (TX) MARK L. THORNTON, M.D., FACP | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $97.76 | 1255330569 - MOHAMMED ISLAM | 760403085 - (TX) GULF COAST CARDIOLOGY GROUP, PLLC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99392 | $118.80 | 1467890772 - LAURO ORTEGA | 742215049 - (TX) DWAYNE ABOUD, M.D., P.A. | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $337.58 | 1225370364 - BRIAN KING | 222768204 - HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC | MA | Pediatrics Physician (208000000X) |
United | 99392 | $90.73 | 1043236201 - BASTROP MEDICAL CLINIC P A | 203210925 - (TX) BASTROP MEDICAL CLINIC P A | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $92.33 | 1972541381 - TOM THAYIL | 752434817 - (TX) M.D. ON CALL, P.A. | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $98.69 | 1124194758 - JOSEPH MILLER | 751939854 - JOSEPH N MILLER | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $141.02 | 1457395360 - RAVI CHANDRASEKHARA | 752390285 - (TX) NORTH TEXAS CARDIOVASCULAR ASS | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99392 | $80.02 | 1083886303 - GRACIELA M LEIJA MD PA | 770701569 - (TX) GRACIELA LEIJA MD PA | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $106.75 | 1962584771 - COPPELL ADULT MEDICINE SPECIALIST | 621874618 - (TX) COPPELL ADULT MEDICINE SPECIALIST | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $351.10 | 1407077407 - QUAN NGUYEN | 752613493 - TEXAS HEALTH PHYSICIANS GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $102.00 | 1881885069 - JESSICA ANDERSON | 20560761 - (TX) CYPRESS PHYSICIANS ASSOCIATION | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $163.07 | 1366678963 - BRIAN COOPER | 854396566 - (NM) ELITE PATIENT CARE NEW MEXICO LLC | TX | Internal Medicine Physician (207R00000X) |
United | 99392 | $141.22 | 1376596155 - HAROON REHMAN | 822363882 - (TX) LA MAGNA HEALTH, PLLC | TX | Internal Medicine Physician (207R00000X) |
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 99392 vs. Other Preventive Medicine Services Codes
The CPT 99392 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 99392 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 | 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 | 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) |
| 99391-CPT | Low | Periodic Comprehensive Preventive Medicine Reevaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling/Anticipatory Guidance/Risk Factor Reduction Interventions And The Ordering Of Laboratorylaboratory/Diagnostic Procedures Established Patient; Infant (Age Under 1 Year) |
| 99392-CPT | Low | Periodic Comprehensive Preventive Medicine Reevaluation And Management Of An Individual Including An Age And Gender Appropriate History Examination Counseling/Anticipatory Guidance/Risk Factor Reduction Interventions And The Ordering Of Laboratorylaboratory/Diagnostic Procedures Established Established Patient; Early Childhood (Age 1 Thr Ough 4 Years) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99392. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99392 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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