CPT 99499 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 • 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 |
National average reimbursement for CPT 99499 by major payers:
$633.19
$378.72
$427.31
$188.67
| 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 99499 | ||||||
United | 99499 | $2008.50 | 1518101096 - WASSIM ABIDA | 133278548 - (NY) MEMORIAL DEVELOPMENTAL CHEMO GROUP | NY | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $2008.50 | 1548573660 - WANQING ZHI | 133278578 - (NY) WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES PC | NY | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $2008.50 | 1083389290 - GILLES SALLES | 133278575 - (NY) MEMORIAL HEMATOLOGY LYMPHOMA GROUP | NY | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $91.00 | 1194187799 - GUISET CARVAJAL BEDOYA | 810231784 - BILLINGS CLINIC | CO | Rheumatology Physician (207RR0500X) |
United | 99499 | $2008.50 | 1154511251 - ZSOFIA STADLER | 300937486 | MA | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $91.00 | 1588229595 - BENJAMIN BELL | 810231784 - BILLINGS CLINIC | GA | Family Medicine Physician (207Q00000X) |
United | 99499 | $35.00 | 1447498688 - WISECARE OF FLORIDA, P.A., ALL FLORIDA FAMILY & SPORTS MEDICINE, P.A. | 263508502 - (FL) WISECARE OF FLORIDA PA | FL | Sports Medicine (Family Medicine) Physician (207QS0010X) |
United | 99499 | $40.00 | 1487755385 - VALLES & ASSOCIATES REHABILITATION SERVICES INC | 710959510 - (FL) VALLES ASSOCIATES REHABILITATION SERVICES INC | FL | Family Medicine Physician (207Q00000X) |
United | 99499 | $91.00 | 1013270156 - AARON AUDET | 810231784 - BILLINGS CLINIC | MT | Family Medicine Physician (207Q00000X) |
United | 99499 | $61.34 | 1124025283 - JAMES TAYLOR | 720683078 | LA | Family Medicine Physician (207Q00000X) |
United | 99499 | $91.00 | 1013270156 - AARON AUDET | 810231784 - BILLINGS CLINIC | MT | Family Medicine Physician (207Q00000X) |
United | 99499 | $2008.50 | 1326235466 - PARASTOO DAHI | 133278575 - (NY) MEMORIAL HEMATOLOGY LYMPHOMA GROUP | NY | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $2008.50 | 1285880039 - SREE BHAVANI CHALASANI | 133278578 - (NY) WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES PC | NJ | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $2008.50 | 1306003793 - JAMES HARDING | 133278548 - (NY) MEMORIAL DEVELOPMENTAL CHEMO GROUP | NY | Hematology & Oncology Physician (207RH0003X) |
United | 99499 | $2008.50 | 1720059769 - KATHARINE HSU | 510616510 - (NY) MSKCC CLINICAL PRACTICE PLAN | NY | Hematology & Oncology Physician (207RH0003X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 | Low | 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 | Low | Work Related Or Medical Disability Examination By The Treating Physician That Includes; Completion Of A Medical History Commensurate With The Patients Condition; Performance Of An Examination Commensurate With The Patients 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 |
| 99456 | Low | Work Related Or Medical Disability Examination By Other Than The Treating Physician That Includes; Completion Of A Medical History Commensurate With The Patients Condition; Performance Of An Examination Commensurate With The Patients 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 |
| 99499 | Moderate | Unlisted Evaluation And Management Services |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 99499) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.