CPT 99602 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 • 11 - Office |
| Common Modifiers | • None • SS - Home infusion services provided in the infusion suite of the IV therapy provider • 26 - Professional component |
| Complexity Level | Moderate |
National average reimbursement for CPT 99602 by major payers:
$70.23
$59.27
$34.69
$50.56
| 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 99602 | ||||||
United | 99602 | $45.90 | 1568451763 - METHODIST CHILDREN'S HOSPITAL, COVENANT HOME INFUSION | 752428911 - (TX) METHODIST CHILDRENS HOSPITAL | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1366441479 - PEN CARE INC, GOLDEN TRIANGLE PHARMACY SERVICES | 760252061 - (TX) PEN CARE INC | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1134231905 - STEPHEN F OWEN, OWEN PHARMACY | 752272411 - (TX) STEPHEN F OWEN | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $65.00 | 1780187237 - OPTUM INFUSION SERVICES 500, INC. | 1780187237 - (TX) OPTUM INFUSION SERVICES 500, INC. | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1912199381 - IV & HOME HEALTH SERVICES OF TEXAS, PHARMACY SPECIALISTS | 208155291 - (TX) IV HOME HEALTH SERVICES OF TEXAS | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1669493631 - INFUSION ASSOC OF W TEXAS LLC, OPTION CARE OF W TEXAS | 10729741 - (TX) INFUSION ASSOC OF W TEXAS LLC | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $45.90 | 1568451763 - METHODIST CHILDREN'S HOSPITAL, COVENANT HOME INFUSION | 752428911 - (TX) METHODIST CHILDRENS HOSPITAL | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $58.70 | 1891703575 - OPTION CARE ENTERPRISES, INC., OPTION CARE | 680208702 - OPTION CARE HEALTH, INC. | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1760400642 - POWERS, DOBBS, & MENZINA, INC., ARISTACARE HEALTH INC. | 752528081 | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1831181072 - MEDWAY INFUSION SERVICES LLC | 50616063 - (TX) MEDWAY INFUSION SERVICES LLC | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1184622318 - ALL HOME INFUSION INC | 752834759 - (TX) ALL HOME INFUSION INC | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1669493631 - INFUSION ASSOC OF W TEXAS LLC, OPTION CARE OF W TEXAS | 10729741 - (TX) INFUSION ASSOC OF W TEXAS LLC | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $40.00 | 1912199381 - IV & HOME HEALTH SERVICES OF TEXAS, PHARMACY SPECIALISTS | 208155291 - (TX) IV HOME HEALTH SERVICES OF TEXAS | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $58.70 | 1922447283 - INFUSION PARTNERS, LLC, BIOSCRIP INFUSION SERVICES | 582102954 | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99602 | $58.70 | 1912930736 - OPTION CARE ENTERPRISES, INC., OPTION CARE | 680208702 - OPTION CARE HEALTH, INC. | TX | Home Infusion Therapy Pharmacy (3336H0001X) |
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 99602 vs. Other Home Health Procedures and Services Codes
The CPT 99602 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 99602 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 |
|---|---|---|
| 99506 | Low | Home Visit For Intramuscular Injections |
| 99507 | Low | Home Visit For Care And Maintenance Of Catheter(S) (Eg, Urinary, Drainage, And Enteral) |
| 99509 | Low | Home Visit For Assistance With Activities Of Daily Living And Personal Care |
| 99602 | Low | Home Infusion/Specialty Drug Administration, Per Visit (Up To 2 Hours); Each Additional Hour (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99602. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99602 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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