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See a sample rate comparisonCPT 99500 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.
Home Visit Prenatal, Home Visit For Prenatal Monitoring And Assessment To Include Fetal Heart Rate Non Stress Test Uterine Monitoring And Gestational Diabetes Monitoring
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Home Health Procedures and Services |
| Common Place of Service | 99 - Other POS |
| Common Modifiers | SS - Home infusion services provided in the infusion suite of the IV therapy provider XP - Separate Practitioner 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99500 |
| Medicaid Fee Schedule | View Medicaid rates for 99500 |
National average reimbursement for CPT 99500 by major payers:
$67.79
$40.00
$50.00
$131.00
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CPT 99500
5 of 25 sample ratesHigher to lower in this preview
Crosbyton Clinic Hospital
$1,272.00Published rateDa Pediatric Rehabilitation
$55.00Published rateRestorative Health Rehabilitation Inc
$40.00Published rateDa Pediatric Rehabilitation
$35.00Published rateGary Chu
Chu Chiropractic Inc
$31.00Published rate
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See a sample payer proposalCPT 99500 vs. Other Home Health Procedures and Services Codes
The CPT 99500 code is part of the Medicine Services and Procedures services used for Home Health Procedures and 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 99500 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 |
|---|---|---|
| 99341-CPT | Low | Home Res Vst New Sf Mdm 15, Home Or Residence Visit For The Evaluation And Management Of A New Patient Which Requires A Medically Appropriate History And Or Examination And Straightforward Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 15 Minutes Must Be Met Or Exceeded |
| 99344-CPT | Moderate | Home Res Vst New Mod Mdm 60, Home Or Residence Visit For The Evaluation And Management Of A New Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 60 Minutes Must Be Met Or Exceeded |
| 99500-CPT | Low | Home Visit Prenatal, Home Visit For Prenatal Monitoring And Assessment To Include Fetal Heart Rate Non Stress Test Uterine Monitoring And Gestational Diabetes Monitoring |
| 99501-CPT | Low | Home Visit For Postnatal Assessment And Follow-Up Care |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99500. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99500 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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