CPT 99484 Fee Schedule

Last Verified: July 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.

Care Mgmt Svc Bhvl Hlth Cond, Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month With The Following Required Elements Initial Assessment Or Follow Up Monitoring Including The Use Of Applicable Validated Rating Scales Behavioral Health Care Planning In Relation To Behavioral Psychiatric Health Problems Including Revision For Patients Who Are Not Progressing Or Whose Status Changes Facilitating And Coordinating Treatment Such As Psychotherapy Pharmacotherapy Counseling And Or Psychiatric Consultation And Continuity Of Care With A Designated Member Of The Care Team

Key Fact	Detail
Service Type	General Behavioral Health Integration Care Management Evaluation and Management
Common Place of Service	11 - Office None
Common Modifiers	None 25 - Significant, separately identifiable E/M service same day GT - Via interactive audio and video telecommunication systems
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 99484

National average reimbursement for CPT 99484 by major payers:

$53.95

$59.96

$48.45

$82.40

Preview provider-level rates for...

For billing codeCPT 99484

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	99484	$38.68	1174771679 - VANDANA SHRIKANTH	760009637 - (TX) LEGACY COMMUNITY HEALTH SERVICES INC	TX	Internal Medicine Physician (207R00000X)
United	99484	$57.04	1174715999 - WILLIAM HOLLAND	461522270 - (TX) BSA PHYSICIANS GROUP INC	TX	Internal Medicine Physician (207R00000X)
United	99484	$90.55	1124106554 - CATHERINE PEREZ	310667480 - (OH) PROFESSIONAL RADIOLOGY, INC.	OH	Diagnostic Radiology Physician (2085R0202X)
United	99484	$82.55	1386796191 - SPENCER MILLER	752536818 - HEALTHTEXAS PROVIDER NETWORK	TX	Neurology Physician (2084N0400X)
United	99484	$27.90	1356320378 - TAMARA BARSIK	462085211 - (TX) CRESCENT DOCTORS GROUP PA	TX	Internal Medicine Physician (207R00000X)
United	99484	$84.87	1548596828 - RUTH PAN	920922704	TX	Internal Medicine Physician (207R00000X)
United	99484	$64.33	1598956773 - MAHMUDA BEGUM	452498998 - (TX) ADULT INPATIENT MEDICAL SERVICES	TX	Internal Medicine Physician (207R00000X)
United	99484	$63.18	1780849950 - RAHULKUMAR SINGH	203325705 - (AZ) APOGEE MEDICAL GROUP TEXAS PA	TX	Internal Medicine Physician (207R00000X)
United	99484	$55.20	1689843518 - MUSHTAQUE AHMED	813193170 - VILLAGEMD OF SOUTHEAST TEXAS, PA	TX	Internal Medicine Physician (207R00000X)
United	99484	$72.52	1629039904 - SHANMUGAM UTHAMALINGAM	300520570 - (TX) METHODIST HOSPITAL	TX	Cardiovascular Disease Physician (207RC0000X)
United	99484	$64.12	1083835540 - BETSY VALADE	42582119 - (MA) COMMUNITY HEALTH PROGRAMS INC	MA	Pediatrics Physician (208000000X)
United	99484	$40.79	1386713329 - RAFIQUDDIN RAHIMI	462923863	TX	Internal Medicine Physician (207R00000X)
United	99484	$52.84	1285697979 - ENRICO AGUAS	751362671 - SEMINOLE HOSPITAL DISTRICT OF GAINES CO., TEXAS	TX	Internal Medicine Physician (207R00000X)
United	99484	$45.95	1578620159 - SAPAN BHATT	742574229 - (TX) WELLMED MEDICAL GROUP, P.A.	TX	Internal Medicine Physician (207R00000X)
United	99484	$133.86	1851611693 - MELLORY KASERMAN	222560501 - (MA) MASS GENERAL BRIGHAM INCORPORATED	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 99484 vs. Other Evaluation and Management Codes

The CPT 99484 code is part of the General Behavioral Health Integration Care Management services used for Evaluation and Management. 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 99484 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
99483-CPT	Moderate	Assmt Care Pln Pt Cog Imp, Assessment Of And Care Planning For A Patient With Cognitive Impairment Requiring An Independent Historian In The Office Or Other Outpatient Home Or Domiciliary Or Rest Home With All Of The Following Required Elements Cognition Focused Evaluation Including A Pertinent History And Examination Medical Decision Making Of Moderate Or High Complexity Functional Assessment Eg Basic And Instrumental Activities Of Daily Living Including Decision Making Capacity Use Of Standardized Instruments For Staging Of Dementia Eg Functional Assessment Staging Test Fast Clinical Dementia Rating Cdr Medication Reconciliation And Review For High Risk Medications Evaluation For Neuropsychiatric And Behavioral Symptoms Including Depression Including Use Of Standardized Screening Instrument S Evaluation Of Safety Eg Home Including Motor Vehicle Operation Identification Of Caregiver S Caregiver Knowledge Caregiver Needs Social Supports And The Willingness Of Caregiver To Take On Caregiving Tasks Development Updating Or Revision Or Review Of An Advance Care Plan Creation Of A Written Care Plan Including Initial Plans To Address Any Neuropsychiatric Symptoms Neuro Cognitive Symptoms Functional Limitations And Referral To Community Resources As Needed Eg Rehabilitation Services Adult Day Programs Support Groups Shared With The Patient And Or Caregiver With Initial Education And Support Typically 60 Minutes Of Total Time Is Spent On The Date Of The Encounter
99484-CPT	Low	Care Mgmt Svc Bhvl Hlth Cond, Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month With The Following Required Elements Initial Assessment Or Follow Up Monitoring Including The Use Of Applicable Validated Rating Scales Behavioral Health Care Planning In Relation To Behavioral Psychiatric Health Problems Including Revision For Patients Who Are Not Progressing Or Whose Status Changes Facilitating And Coordinating Treatment Such As Psychotherapy Pharmacotherapy Counseling And Or Psychiatric Consultation And Continuity Of Care With A Designated Member Of The Care Team
99487-CPT	Low	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99489-CPT	Low	Cplx Chrnc Care Ea Addl 30, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month List Separately In Addition To Code For Primary Procedure

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99484. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99484 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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