CPT 99501 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 | • Medicine Services and Procedures • Home Health Procedures and Services |
| Common Place of Service | • None • 99 - Other POS |
| Common Modifiers | • None • AT - Acute or Active Treatment • HD |
| Complexity Level | Low |
National average reimbursement for CPT 99501 by major payers:
$68.53
$55.00
$50.00
$69.80
| 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 99501 | ||||||
United | 99501 | $135.00 | 1609858083 - THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, GOOD SAMARITAN CARES | 450228055 - THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | FL | Home Health Agency (251E00000X) |
United | 99501 | $80.00 | 1730372640 - AMERICAN NEW VISION, LLC, HOME HEALTH SERVICES OF BROWARD | 383760880 - (FL) AMERICAN NEW VISION, LLC | FL | Home Health Agency (251E00000X) |
United | 99501 | $40.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 99501 | $55.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 99501 | $80.00 | 1588684815 - PRIMARY MEDICAL STAFFING, INC. | 320154697 - (FL) PRIMARY MEDICAL STAFFING INC | FL | Home Health Agency (251E00000X) |
United | 99501 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 99501 | $55.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 99501 | $68.73 | 1831346006 - RAM BALASUBRAMANIAN | 823898488 | AL | Interventional Cardiology Physician (207RI0011X) |
United | 99501 | $80.00 | 1487651915 - TEHC, LLC, TEHC HEALTHCARE | 582490515 - (FL) TEHC HEALTHCARE, LLC | FL | Home Health Agency (251E00000X) |
United | 99501 | $60.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 99501 | $100.00 | 1477556751 - PRIME CARE HEALTH AGENCY, INC, PRINCIPLE HEALTH SERVICES | 592596595 - (FL) PRIME CARE HEALTH AGENCY INC | FL | Home Health Agency (251E00000X) |
United | 99501 | $55.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 99501 | $55.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 99501 | $60.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 99501 | $100.00 | 1497788590 - KARING NURSING REGISTRY, INC. | 113745079 - (FL) KARING NURSING REGISTRY INC | FL | Home Health Agency (251E00000X) |
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 99501 vs. Other Home Health Procedures and Services Codes
The CPT 99501 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 99501 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 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. (Desc Rvsd 1/1/23) |
| 99344-CPT | Moderate | 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. (Desc Rvsd 1/1/23) |
| 99350-CPT | High | Home Or Residence Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And High 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.(Desc Rvsd 1/1/23) |
| 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 99501. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99501 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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