How much does Medicare pay for CPT 99344?

Medicare allowed an average of $127.50 per service and paid $93.62 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $273.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99344?

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes. It was billed 200,192 times to 200,112 Medicare beneficiaries by 5,042 providers in 2024.

Does 99344 pay differently in an office than a hospital?

Yes. The allowed amount averaged $127.50 in an office setting and $138.85 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99344 most?

Nurse Practitioner, with 110,062 services from 3,199 clinicians. Next are Podiatry, Internal Medicine, Physician Assistant.

CPT 99344

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes

$127.50Medicare-allowed amount per service, averaged across 200,192 services

Providers submitted

$273.79

Asking price, not received

Medicare allowed

$127.50

The fee schedule figure

Medicare paid

$93.62

Balance is patient coinsurance

Providers submitted an average of $273.79 for this code and Medicare allowed $127.50 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $93.62 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $127.50
Hospital / facility: $138.85

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 200,156 services were billed in an office setting and 36 in a facility.

Services: 200,192
Beneficiaries: 200,112
Providers billing it: 5,042
Total allowed: $25,524,480

What Medicare pays for CPT 99344

Across 200,192 services billed by 5,042 providers to 200,112 beneficiaries, Medicare allowed an average of $127.50 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99344

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	110,062	110,009	$118.96	3,199
Podiatry	25,465	25,459	$141.03	320
Internal Medicine	19,402	19,395	$143.48	419
Physician Assistant	17,464	17,459	$120.54	421
Family Practice	11,453	11,449	$141.58	306
Emergency Medicine	2,901	2,901	$142.04	63
General Practice	2,086	2,082	$141.77	56
Geriatric Medicine	2,026	2,026	$142.86	54
Psychiatry	1,747	1,746	$141.54	36
Optometry	1,614	1,614	$139.05	15
Cardiology	655	655	$145.62	19
Hospice and Palliative Care	648	648	$146.41	16
Plastic and Reconstructive Surgery	501	501	$148.76	5
Hospitalist	468	468	$146.78	11
General Surgery	427	427	$144.84	17

99344 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	36,486	$125.29	$92.04	785
California	31,544	$134.77	$93.93	463
New York	14,073	$143.28	$97.18	261
Illinois	13,333	$133.47	$96.72	290
Texas	12,130	$125.44	$93.21	345
New Jersey	7,685	$137.98	$95.98	198
Arizona	6,696	$120.55	$88.51	168
Michigan	6,354	$128.00	$93.37	185
Nevada	5,630	$119.38	$88.78	105
North Carolina	5,048	$115.60	$88.10	154
Ohio	4,827	$120.14	$88.75	191
Maryland	4,657	$129.11	$91.13	121
Virginia	4,544	$123.20	$89.32	156
Pennsylvania	3,976	$126.19	$93.63	147
Washington	3,617	$124.48	$81.11	106
South Carolina	3,101	$118.11	$88.82	108
Tennessee	3,047	$117.80	$87.68	100
Oklahoma	2,918	$122.18	$91.56	70
Georgia	2,572	$124.10	$91.83	81
Kentucky	2,397	$117.65	$89.16	62
Massachusetts	2,108	$129.42	$90.60	67
Indiana	2,070	$117.78	$87.37	97
Minnesota	1,889	$118.69	$84.67	79
Alabama	1,722	$114.00	$89.28	48
Colorado	1,476	$122.77	$86.40	71
Missouri	1,353	$121.99	$93.60	49
Utah	1,329	$115.73	$83.57	48
Arkansas	1,319	$113.65	$90.04	52
Kansas	1,273	$113.38	$84.28	43
Wisconsin	1,240	$117.82	$87.82	45
Mississippi	1,189	$113.42	$89.72	45
Connecticut	1,161	$127.59	$87.51	50
Idaho	1,017	$113.24	$82.74	35
Nebraska	791	$114.95	$85.00	17
West Virginia	728	$132.15	$90.65	15
Louisiana	719	$114.63	$88.20	34
Iowa	605	$117.20	$89.05	23
New Hampshire	535	$125.23	$89.44	19
District of Columbia	516	$137.73	$94.29	14
Oregon	395	$120.40	$83.13	21
Delaware	383	$128.11	$93.14	14
New Mexico	261	$120.97	$85.30	15
Maine	254	$127.31	$89.91	9
Rhode Island	226	$129.39	$90.88	7
Hawaii	219	$132.16	$91.15	4
Montana	143	$124.23	$84.63	6
South Dakota	126	$126.95	$93.34	3
North Dakota	119	$116.34	$82.57	5
Alaska	111	$158.75	$78.07	2
Wyoming	102	$116.99	$88.39	2
Guam	69	$118.91	$82.11	2
Puerto Rico	30	$138.59	$98.75	1
AP	24	$156.91	$110.39	1
XX	24	$116.86	$85.00	1
U.S. Virgin Islands	18	$138.66	$76.40	1
Vermont	13	$115.24	$79.53	1

Related codes

99309Subsequent nursing facility care$96.76
99308Subsequent nursing facility care$68.91
99349Residence visit for established patient$111.27
99310Subsequent nursing facility care$136.30
99348Residence visit for established patient$69.57
99307Subsequent nursing facility care$38.21
99306Initial nursing facility care$173.94
99350Residence visit for established patient$162.36
99305Initial nursing facility care$126.36
99347Residence visit for established patient$42.71
99316Nursing facility discharge management$116.89
99304Initial nursing facility care$76.99

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.