Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 99446 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.
Ntrprof Ph1 Ntrnet Ehr 5 10, 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 Patient S Treating Requesting Physician Or Other Qualified Health Care Professional 5 10 Minutes Of Medical Consultative Discussion And Review
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Non-Face-to-Face Services |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 95 - Telemedicine - audio and video GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $19.04 national non-facility rate (2026) · View Medicare rates for 99446 |
| Medicaid Fee Schedule | $15.19 median of the 8 states in the free preview · View Medicaid rates for 99446 |
National average reimbursement for CPT 99446 by major payers:
$35.98
$21.59
$41.11
$41.67
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 99446.
CPT 99446
5 of 25 sample ratesHigher to lower in this preview
Derek Trapasso
Mass General Brigham Incorporated
$88.33Published rateCathleen Renzi
Tufts Medical Center Physicians Organization Inc
$45.47Published rateMary Colpoys
Iccd Partners LLP
$23.71Published rateSyed Hasnain
Family Health Consultants, P.A.
$18.40Published rateHector Carbajal
Houston Hospicare PLLC
$15.60Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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) |
| 99446-CPT | Low | Ntrprof Ph1 Ntrnet Ehr 5 10, 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 Patient S Treating Requesting Physician Or Other Qualified Health Care Professional 5 10 Minutes Of Medical Consultative Discussion And Review |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 99446) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
To find the cost of a specific medical procedure, it's best to have the relevant CPT code and your specific location. While your insurance company can provide estimates for services covered under your plan, for a comprehensive search of fee schedules based on CPT code and specific location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool designed for this purpose.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. It's crucial for understanding medical costs because it standardizes the services billed, allowing for accurate pricing and insurance claims processing. Without a CPT code, it's difficult to get an exact price quote for a specific service.
Fee schedules for specific medical services vary widely based on the healthcare provider, the insurance company (payer), and the geographic location. While some general pricing data might be publicly available, obtaining precise, up-to-date fee schedules for a particular CPT code and your specific location often requires specialized tools. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to find relevant pricing information.
Location significantly impacts medical costs due to variations in local cost of living, supply and demand for services, hospital operating costs, regional labor costs for medical staff, and competition among healthcare providers. A procedure in a major metropolitan area might cost more than the same procedure in a rural area, even within the same state. Pricing tools often require your location to provide accurate estimates.
A 'billed charge' is the full price that a healthcare provider initially charges for a service, often much higher than what insurance companies or patients actually pay. A 'negotiated rate' (or allowed amount) is the discounted price that an insurance company and a healthcare provider have agreed upon for a specific service. Patients with insurance typically pay a portion of the negotiated rate (e.g., deductible, copay, coinsurance), while uninsured patients might be expected to pay the billed charge or a discounted self-pay rate if negotiated.
Comparing prices for healthcare services is crucial for informed decision-making. You can start by asking your provider for an estimate, checking your insurance company's online portal for cost estimators, or using independent pricing tools. For a detailed comparison based on specific CPT codes and your location, Payerprice provides a fee schedule lookup tool that can help you understand the potential costs of various services in your area.