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See a sample rate comparisonCPT 99602 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 Nfs Visit Each Addl Hr, Home Infusion/Specialty Drug Administration Per Visit (Up To 2 Hours); Each Additional Hour (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Home Health Procedures and Services |
| Common Place of Service | 99 - Other POS 11 - Office |
| Common Modifiers | SS - Home infusion services provided in the infusion suite of the IV therapy provider 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99602 |
| Medicaid Fee Schedule | $32.85 median of the 3 states in the free preview · View Medicaid rates for 99602 |
National average reimbursement for CPT 99602 by major payers:
$70.23
$59.27
$34.69
$50.57
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CPT 99602
5 of 25 sample ratesHigher to lower in this preview
Option Care Enterprises, Inc.
Option Care Health, Inc.
$75.00Published rateSoleo Health Inc.
$52.87Published rateMethodist Children'S Hospital, Covenant Home Infusion
Methodist Childrens Hospital
$45.90Published rateBinson'S Medical Equipment, Inc.
Binsons Medical Equipment Inc
$40.00Published rateBronson At Home, Bah Infusion Services
Bronson At Home
$40.00Published rate
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See a sample payer proposalCPT 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-CPT | Low | Home Visit For Intramuscular Injections |
| 99600-CPT | Moderate | Home Visit Service, A Visit Or Treatment In The Home By A Health Care Professional. |
| 99601-CPT | Low | Home Infus/Specialty Drug Administr Per Visit (Up To 2 Hrs), Home Infusion/Specialty Drug Administration Per Visit (Up To 2 Hours) |
| 99602-CPT | Low | Home Nfs Visit Each Addl Hr, 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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