Evaluation & Management
| CPT Code | Description | Billed Charge ($) | Average Commercial Rate ($) | Medicare Rate ($) | Medical Assistance Rate ($) |
|---|---|---|---|---|---|
| 99202 | Office Visit, New Patient, 15-29 minutes | 178.00 | 159.43 | 69.22 | 54.16 |
| 99203 | Office Visit, New Patient, 30-44 minutes | 275.00 | 222.51 | 106.69 | 83.05 |
| 99204 | Office Visit, New Patient, 45-59 minutes | 412.00 | 332.00 | 159.70 | 124.46 |
| 99212 | Office Visit, Established Patient, 10-19 minutes | 140.00 | 113.70 | 54.63 | 42.67 |
| 99213 | Office Visit, Established Patient, 20-29 minutes | 224.00 | 182.24 | 87.78 | 68.32 |
| 99214 | Office Visit, Established Patient, 30-39 minutes | 316.00 | 256.89 | 123.24 | 96.26 |
| 99215 | Office Visit, Established Patient, 40-54 minutes | 445.00 | 361.07 | 172.84 | 135.12 |
| 99490 | Chronic Care Management | 155.00 | 130.32 | 59.78 | 0.00 |
| 99495 | Transition Care Mgmt 14 Day From Discharge | 510.00 | 432.90 | 199.99 | 156.46 |
| 99496 | Transition Care Mgmt 7 Day From Discharge | 689.00 | 585.80 | 270.80 | 211.83 |
Preventive Services
| CPT Code | Description | Billed Charge ($) | Average Commercial Rate ($) | Medicare Rate ($) | Medical Assistance Rate ($) |
|---|---|---|---|---|---|
| 99385 | Preventive Care New Patient Age 18-39 | 318.00 | 259.29 | 0.00 | 97.28 |
| 99391 | Preventive Care Established Patient Age <1 Year | 242.00 | 197.28 | 0.00 | 74.16 |
| 99392 | Preventive Care Established Patient Age 1-4 | 251.00 | 211.24 | 0.00 | 77.05 |
| 99393 | Preventive Care Established Patient Age 5-11 | 256.00 | 209.97 | 0.00 | 78.48 |
| 99394 | Preventive Care Established Patient Age 12-17 | 280.00 | 228.48 | 0.00 | 85.85 |
| 99395 | Preventive Care Established Patient Age 18-39 | 287.00 | 233.49 | 0.00 | 87.63 |
| 99396 | Preventive Care Established Patient Age 40-64 | 305.00 | 248.19 | 0.00 | 92.96 |
| 99397 | Preventive Care Established Patient Age 65 and Over | 328.00 | 267.39 | 0.00 | 100.33 |
| G0438 | Annual Wellness Visit, Initial | 408.00 | 280.76 | 158.59 | 121.47 |
| G0439 | Annual Wellness Visit, Subsequent | 321.00 | 221.11 | 125.04 | 95.68 |
Other
| CPT Code | Description | Billed Charge ($) | Average Commercial Rate ($) | Medicare Rate ($) | Medical Assistance Rate ($) |
|---|---|---|---|---|---|
| 80048 | Basic Metabolic Panel | 24.00 | 9.22 | 8.46 | 8.46 |
| 80053 | Comprehensive Metabolic Panel | 30.00 | 11.45 | 10.56 | 10.56 |
| 80061 | Lipid Panel | 35.00 | 14.57 | 13.39 | 13.39 |
| 83036 | Glycosylated Hemoglobin (A1C) | 27.00 | 10.60 | 9.71 | 9.71 |
| 84443 | Thyroid Stimulating Hormone (TSH) | 50.00 | 18.22 | 16.80 | 16.80 |