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See a sample rate comparisonCPT 99499 Fee Schedule
Last Verified: September 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.
Unlisted Evaluation And Manage, Unlisted Evaluation And Management Service
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Other Evaluation and Management Services |
| Common Place of Service | 11 - Office None 99 - Other POS |
| Common Modifiers | None 95 - Telemedicine - audio and video 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 99499 |
National average reimbursement for CPT 99499 by major payers:
$633.19
$378.72
$427.31
$192.24
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CPT 99499
5 of 25 sample ratesHigher to lower in this preview
Oscar Lahoud
Msk Nassau
$2,008.50Published rateSherry Shen
Westchester Medical Center Advanced Physician Services PC
$2,008.50Published rateRaghu Kunamneni
$2,008.50Published rateSeth Larson
Billings Clinic
$91.00Published rateValles & Associates Rehabilitation Services Inc
Valles Associates Rehabilitation Services Inc
$40.00Published rate
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See a sample payer proposalCPT 99499 vs. Other Other Evaluation and Management Services Codes
The CPT 99499 code is part of the Evaluation and Management services used for Other Evaluation and Management 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 99499 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 |
|---|---|---|
| 99450-CPT | Low | Basic Life Disability Exam, Basic Life And Or Disability Examination That Includes: Measurement Of Height Weight And Blood Pressure Completion Of A Medical History Following A Life Insurance Pro Forma Collection Of Blood Sample And Or Urinalysis Complying With Chain Of Custody Protocols And Completion Of Necessary Documentation Certificates. |
| 99455-CPT | Low | Work Related Disability Exam, Work Related Or Medical Disability Examination By The Treating Physician That Includes Completion Of A Medical History Commensurate With The Patient S Condition Performance Of An Examination Commensurate With The Patient S Condition Formulation Of A Diagnosis Assessment Of Capabilities And Stability And Calculation Of Impairment Development Of Future Medical Treatment Plan And Completion Of Necessary Documentation Certificates And Report |
| 99456-CPT | Low | Disability Examination, Work Related Or Medical Disability Examination By Other Than The Treating Physician That Includes Completion Of A Medical History Commensurate With The Patient S Condition Performance Of An Examination Commensurate With The Patient S Condition Formulation Of A Diagnosis Assessment Of Capabilities And Stability And Calculation Of Impairment Development Of Future Medical Treatment Plan And Completion Of Necessary Documentation Certificates And Report |
| 99499-CPT | Moderate | Unlisted Evaluation And Manage, Unlisted Evaluation And Management Service |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99499 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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