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See a sample rate comparisonCPT 99502 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 For Newborn Care And Assessment
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Home Health Procedures and Services |
| Common Place of Service | 99 - Other POS |
| Common Modifiers | EP - Residential facility to Physician's office 32 |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99502 |
| Medicaid Fee Schedule | $57.29 median of the 6 states in the free preview · View Medicaid rates for 99502 |
National average reimbursement for CPT 99502 by major payers:
$75.90
$55.00
$50.00
$56.13
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CPT 99502
5 of 25 sample ratesHigher to lower in this preview
The Evangelical Lutheran Good Samaritan Society, Good Samaritan Cares
The Evangelical Lutheran Good Samaritan Society
$135.00Published rateDa Pediatric Rehabilitation
$60.00Published rateDa Pediatric Rehabilitation
$55.00Published rateAll Ways Homecare Inc
$40.00Published rateDa Pediatric Rehabilitation
$35.00Published rate
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See a sample payer proposalCPT 99502 vs. Other Home Health Procedures and Services Codes
The CPT 99502 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 99502 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 |
|---|---|---|
| 99502-CPT | Low | Home Visit For Newborn Care And Assessment |
| 99503-CPT | Low | Home Breathing Therapy, Home Visit For Care Related To A Breathing Condition. The Visit Can Include Education Therapy Medication Management And Equipment Calibration. |
| 99505-CPT | Low | Home Visit For Stoma Care, Home Visit For Care Of Stoma (Surgically Created Opening In The Skin) And Maintenance Of Colostomy (Opening In Abdomen From Large Intestine) Or Cystoma (Opening In Abdominal Wall For Drainage Of Urine From Bladder). |
| 99507-CPT | Low | Home Visit For Care & Maintenan Of Cathet(S) (Eg Urinary Drain, Home Visit For Care And Maintenance Of Catheter(S) (Eg Urinary Drain |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99502. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99502 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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