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See a sample rate comparisonCPT 99449 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 31, 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 31 Minutes Or More Of Medical Consultative Discussion And Review
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Non-Face-to-Face Services |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 95 - Telemedicine - audio and video GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| Medicare Fee Schedule | $76.15 national non-facility rate (2026) · View Medicare rates for 99449 |
| Medicaid Fee Schedule | $60.555 median of the 8 states in the free preview · View Medicaid rates for 99449 |
National average reimbursement for CPT 99449 by major payers:
$97.93
$86.38
$81.56
$128.90
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CPT 99449
5 of 25 sample ratesHigher to lower in this preview
Suzanne Boxer
Mass General Brigham Incorporated
$353.39Published rateEmily Bowen
Fmc Longterm Care PA
$106.68Published rateIram Qureshi
Bella Healthcare Lp
$77.68Published rateDorothy Pei
Rajiv Agarwal Md PA
$66.58Published rateFrancisco C Rodriguez Md & Associates
Francisco C. Rodriguez Md & Assoc. Employees' Pension Plan
$44.38Published rate
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See a sample payer proposalCPT 99449 vs. Other Non-Face-to-Face Services Codes
The CPT 99449 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 99449 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 |
|---|---|---|
| 99447-CPT | Low | Ntrprof Ph1 Ntrnet Ehr 11 20, 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 11 20 Minutes Of Medical Consultative Discussion And Review |
| 99448-CPT | Low | Ntrprof Ph1 Ntrnet Ehr 21 30, 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 21 30 Minutes Of Medical Consultative Discussion And Review |
| 99449-CPT | Low | Ntrprof Ph1 Ntrnet Ehr 31, 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 31 Minutes Or More Of Medical Consultative Discussion And Review |
| 99451-CPT | Low | Ntrprof Ph1 Ntrnet Ehr 5, Interprofessional Telephone Internet Electronic Health Record Assessment And Management Service Provided By A Consultative Physician Or Other Qualified Health Care Professional Including A Written Report To The Patient S Treating Requesting Physician Or Other Qualified Health Care Professional 5 Minutes Or More Of Medical Consultative Time |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99449. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99449 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
To find out the estimated cost of a specific medical procedure before you get it, you should ideally contact your healthcare provider directly for an estimate, and also your insurance company to understand your coverage, deductible, and out-of-pocket maximums. For a more direct way to look up fee schedules based on CPT code and specific location, you can use tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes to get an idea of the pricing.
A CPT (Current Procedural Terminology) code is a five-digit code used by healthcare providers to describe medical, surgical, and diagnostic services. Each service you receive from a healthcare provider will have a CPT code associated with it. These codes are crucial for billing and reimbursement, as they standardize the reporting of medical procedures. Understanding the CPT code for a procedure you are considering can help you research its typical cost. You can use tools like Payerprice, which allows searching by CPT code, to find fee schedule information.
To understand how much your insurance might pay for a procedure, you should first contact your insurance provider directly. They can explain your specific benefits, including deductibles, co-pays, co-insurance, and any pre-authorization requirements for the procedure. You can also research typical costs and fee schedules for procedures using their CPT codes. For specific fee schedule lookup based on CPT code and location, Payerprice provides a tool that can assist in understanding potential costs that influence insurance payments.
The final cost of a medical service can be influenced by several factors, including the type and complexity of the procedure, the healthcare provider's fees, the facility where the service is performed (e.g., hospital vs. outpatient clinic), your geographic location, your insurance plan's negotiated rates, your deductible, co-pay, and co-insurance. The CPT code identifies the specific service, but the actual price can vary widely. To get more specific fee schedule information that takes location and CPT code into account, you can use a tool like Payerprice.