How much does Medicare pay for CPT 99449?

Medicare allowed an average of $70.73 per service and paid $54.26 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $198.36, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99449?

Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes. It was billed 3,300 times to 2,833 Medicare beneficiaries by 105 providers in 2024.

Does 99449 pay differently in an office than a hospital?

Yes. The allowed amount averaged $69.57 in an office setting and $71.09 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 99449 most?

Neurology, with 1,027 services from 39 clinicians. Next are Cardiology, Pulmonary Disease, Infectious Disease.

CPT 99449

Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes

$70.73Medicare-allowed amount per service, averaged across 3,300 services

Providers submitted

$198.36

Asking price, not received

Medicare allowed

$70.73

The fee schedule figure

Medicare paid

$54.26

Balance is patient coinsurance

Providers submitted an average of $198.36 for this code and Medicare allowed $70.73 — 2.8× 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 $54.26 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $69.57
Hospital / facility: $71.09

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 786 services were billed in an office setting and 2,514 in a facility.

Services: 3,300
Beneficiaries: 2,833
Providers billing it: 105
Total allowed: $233,409

What Medicare pays for CPT 99449

Across 3,300 services billed by 105 providers to 2,833 beneficiaries, Medicare allowed an average of $70.73 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 99449

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	1,027	1,019	$71.71	39
Cardiology	367	311	$74.01	6
Pulmonary Disease	318	169	$68.23	1
Infectious Disease	291	275	$69.40	15
Physical Medicine and Rehabilitation	215	213	$64.35	1
Internal Medicine	171	155	$69.47	6
Nurse Practitioner	165	131	$63.30	7
Anesthesiology	156	49	$73.04	2
Hematology-Oncology	138	134	$77.55	8
General Surgery	80	29	$73.04	1
Psychiatry	64	62	$74.41	2
Nephrology	60	57	$69.53	2
Obstetrics & Gynecology	37	29	$71.88	2
Rheumatology	35	35	$66.15	1
Orthopedic Surgery	31	21	$73.24	1

99449 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
California	1,128	$72.52	$52.71	21
Texas	416	$68.65	$54.08	5
New York	193	$74.56	$50.29	8
Georgia	187	$71.23	$54.93	6
Pennsylvania	176	$69.33	$54.59	12
Maryland	174	$72.51	$53.09	4
District of Columbia	143	$71.91	$54.46	3
Ohio	86	$67.90	$51.23	4
Iowa	81	$65.82	$54.05	4
Illinois	71	$69.08	$54.36	2
North Carolina	59	$65.62	$51.45	3
Tennessee	57	$62.26	$51.99	3
Massachusetts	55	$71.56	$55.66	3
New Jersey	52	$75.55	$50.12	3
Delaware	51	$73.44	$54.03	2
Nevada	42	$65.57	$50.48	2
West Virginia	40	$70.23	$55.59	2
Idaho	35	$66.15	$52.47	1
Michigan	34	$69.55	$55.40	2
Kansas	32	$68.08	$50.51	1
Mississippi	27	$56.07	$43.79	2
Wisconsin	23	$67.23	$55.51	2
Colorado	22	$69.59	$48.00	2
Rhode Island	21	$69.39	$44.27	1
Florida	18	$66.05	$52.66	1
Alabama	14	$68.69	$55.33	1
Oregon	14	$67.87	$55.46	1
Virginia	13	$75.58	$46.83	1
Arizona	13	$72.51	$55.17	1
Indiana	12	$66.33	$55.59	1
Washington	11	$76.22	$55.59	1

Related codes

99490Chronic care management services$59.70
99439Chronic care management services for two or more chronic conditions$46.13
99497Advance care planning$73.95
99457Management using the results of remote vital sign monitoring per calen$48.61
99458Management using the results of remote vital sign monitoring per calen$39.11
99454Remote monitoring of physiologic parameters$47.97
99489Complex chronic care management services for two or more chronic condi$67.00
99442Telephone medical discussion$83.84
99443Telephone medical discussion$120.39
99487Complex chronic care management services for two or more chronic condi$124.70
99496Transitional care management services for problem of high complexity$252.87
99426Principal care management services for a single high-risk disease$60.08

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.