CPT 99446 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 • Non-Face-to-Face Services |
| Common Place of Service | • 11 - Office • None • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 95 - Telemedicine - audio and video • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 99446 by major payers:
$35.98
$21.59
$41.11
$40.27
| 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 99446 | ||||||
United | 99446 | $41.47 | 1972770246 - ARTURO DOMINGUEZ | 330676831 - HOAG CLINIC INC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 99446 | $19.32 | 1952366684 - MARC DEMYUN | 850531864 - (TX) AD PRECISION MEDICAL PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $21.54 | 1558308551 - DEVANSHI GUPTA | 263508350 - (TX) DEVANSHI GUPTA MD PA | TX | Neurology Physician (2084N0400X) |
United | 99446 | $16.56 | 1689135451 - CAILA MAGAZINE | 311756818 - (TX) ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $88.33 | 1033136833 - DEREK TRAPASSO | 42697983 - MASS GENERAL BRIGHAM INCORPORATED | MA | Pediatrics Physician (208000000X) |
United | 99446 | $59.50 | 1104243104 - KISHAN PRASAD TALAGADADEEVI | 752613493 - TEXAS HEALTH PHYSICIANS GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $26.51 | 1245230622 - RAJESH PATEL | 752368382 - (TX) RAJESH J PATEL MD PA | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $21.00 | 1184626392 - JOHN CURANOVIC | 870692812 - (TX) PRIMARY CARE PHYSICIANS OF TEXAS, PA | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $88.33 | 1467408955 - TAKARA STANLEY | 42807148 - MASS GENERAL BRIGHAM INCORPORATED | MA | Pediatrics Physician (208000000X) |
United | 99446 | $18.40 | 1992755953 - SYED HASNAIN | 731646482 - (TX) FAMILY HEALTH CONSULTANTS, P.A. | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $45.97 | 1437116654 - ABBY LEVINE | 43546292 - (MA) WESTWOOD-MANSFIELD PEDIATRIC ASSOCIATES, P.C. | MA | Pediatrics Physician (208000000X) |
United | 99446 | $15.64 | 1689733669 - THIMOS PASCHALIS | 832912439 - (TX) INTERNIST CHRONIC CARE MANAGEMENT LLC | TX | Internal Medicine Physician (207R00000X) |
United | 99446 | $23.71 | 1881749216 - MARY COLPOYS | 260342759 - (MA) ICCD PARTNERS LLP | MA | Pediatrics Physician (208000000X) |
United | 99446 | $45.97 | 1598858367 - JEFFREY FELDMAN | 43454389 - (MA) JEFFREY S. FELDMAN, M.D. | MA | Pediatrics Physician (208000000X) |
United | 99446 | $38.13 | 1235178229 - JOHN DALLENBACH | 222547186 - (VT) CENTRAL VERMONT MEDICAL CENTER INC HCSR | MA | Pediatrics Physician (208000000X) |
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 99446 vs. Other Non-Face-to-Face Services Codes
The CPT 99446 code is part of the Evaluation and Management services used for Non-Face-to-Face 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 99446 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 |
|---|---|---|
| 99415-CPT | Low | Prolonged Clinical Staff Service (The Service Beyond The Highest Time In The Range Of Total Timeof The Service) During An Evaluation And Management Service In The Office Or Outpatient Setting Direct Patient Contact With Physician Supervision; First Hour (List Separately In Addition To Code For Outpatient Evaluation And Management Service) (Desc Rvsd 1/1/21) |
| 99416-CPT | Low | Prolonged Clinical Staff Service (The Service Beyond The Highest Time In The Range Of Total Timeof The Service) During An Evaluation And Management Service In The Office Or Outpatient Setting Direct Patient Contact With Physician Supervision; Each Additional 30 Minutes (List Separately In Addition To Code For Prolonged Service) (Desc Rvsd 1/1/21) |
| 99441-CPT | Low | Telephone Evaluation And Management Service By A Physician Or Other Qualified Health Care Professional Who May Report Evaluation And Management Services Provided To An Established Patient Parent Or Guardian Not Orginating From Arelated E/M Service Provided Within The Previous 7days Nor Leading To An E/M Service Or Procedure Within The Next 24 Hours Or Soonest Available Appointment; 5-10 Minutes Of Medical Discussion (Revised 01/01/13) |
| 99446-CPT | Low | Interprofessional Telephone/Internet/Electronic Health Record Assessment And Management Service Provided By A Consultative Physician Or Other Qualified Health Care Professional Including A Verbal And Written Report To The Patients Treating/Requesting Physician Or Other Qualified Health Care Professional;5-10 Minutes Of Medical Consultative Discussion And Review (Desc Rvsd 1/1/23) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99446. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99446 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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