How much does Medicare pay for CPT 99483?

Medicare allowed an average of $251.08 per service and paid $188.85 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $496.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99483?

Assessment of and care planning for patient with impaired thought processing, typically 60 minutes. It was billed 127,353 times to 117,372 Medicare beneficiaries by 2,003 providers in 2024.

Does 99483 pay differently in an office than a hospital?

Yes. The allowed amount averaged $256.46 in an office setting and $180.71 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 99483 most?

Nurse Practitioner, with 43,967 services from 713 clinicians. Next are Neurology, Internal Medicine, Family Practice.

CPT 99483

Assessment of and care planning for patient with impaired thought processing, typically 60 minutes

$251.08Medicare-allowed amount per service, averaged across 127,353 services

Providers submitted

$496.47

Asking price, not received

Medicare allowed

$251.08

The fee schedule figure

Medicare paid

$188.85

Balance is patient coinsurance

Providers submitted an average of $496.47 for this code and Medicare allowed $251.08 — 2.0× 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 $188.85 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $256.46
Hospital / facility: $180.71

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 118,317 services were billed in an office setting and 9,036 in a facility.

Services: 127,353
Beneficiaries: 117,372
Providers billing it: 2,003
Total allowed: $31,975,791

What Medicare pays for CPT 99483

Across 127,353 services billed by 2,003 providers to 117,372 beneficiaries, Medicare allowed an average of $251.08 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 99483

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	43,967	40,343	$222.94	713
Neurology	29,421	26,771	$268.58	412
Internal Medicine	25,104	23,406	$273.48	349
Family Practice	11,064	10,295	$265.69	222
Geriatric Medicine	6,274	5,837	$248.86	108
Physician Assistant	4,428	4,129	$216.30	81
General Practice	1,886	1,781	$283.40	27
Psychiatry	1,702	1,522	$264.14	22
Cardiology	615	578	$295.00	13
Diagnostic Radiology	587	546	$302.87	2
Emergency Medicine	540	501	$278.19	9
Hospitalist	329	323	$241.85	8
Obstetrics & Gynecology	192	189	$266.31	1
Certified Clinical Nurse Specialist	171	165	$225.01	6
Osteopathic Manipulative Medicine	160	156	$286.27	2

99483 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	30,256	$267.65	$188.80	311
Florida	16,348	$249.24	$189.51	260
Texas	10,569	$244.22	$188.13	168
New York	9,996	$284.00	$194.64	174
Arizona	4,511	$233.07	$180.15	84
Michigan	4,325	$232.49	$177.07	93
New Jersey	4,217	$286.28	$197.55	68
Pennsylvania	3,155	$242.77	$175.41	52
Illinois	3,060	$252.55	$187.02	48
Maryland	2,550	$244.59	$174.42	50
North Carolina	2,505	$223.78	$172.45	45
Ohio	2,418	$198.53	$147.18	35
Tennessee	2,187	$230.27	$180.35	26
Colorado	2,072	$242.78	$179.70	64
Virginia	2,056	$244.39	$172.53	36
South Carolina	1,851	$238.54	$184.96	27
Kansas	1,822	$220.48	$163.33	22
Missouri	1,767	$214.43	$160.48	22
Utah	1,687	$212.80	$163.27	33
Georgia	1,600	$249.56	$186.46	40
Oklahoma	1,377	$224.40	$172.08	21
District of Columbia	1,314	$296.97	$208.65	14
Massachusetts	1,313	$251.38	$175.83	23
Washington	1,244	$254.52	$169.16	23
Alabama	1,094	$216.98	$171.96	18
Nevada	1,041	$234.78	$183.47	25
Indiana	969	$229.19	$172.54	24
Louisiana	876	$215.28	$172.00	16
Mississippi	785	$237.90	$192.80	17
Connecticut	780	$281.52	$191.63	22
West Virginia	732	$242.43	$187.10	8
Arkansas	716	$185.12	$147.10	11
Oregon	705	$262.29	$181.18	10
Delaware	648	$242.63	$186.55	7
Nebraska	593	$205.49	$172.12	17
Hawaii	533	$275.94	$191.63	12
Minnesota	505	$253.34	$184.93	12
Kentucky	476	$237.26	$182.27	11
Wisconsin	475	$213.46	$166.30	11
Iowa	382	$209.68	$161.94	6
Idaho	375	$214.89	$180.56	6
Alaska	362	$286.98	$172.28	2
New Mexico	255	$237.84	$184.80	5
South Dakota	195	$221.15	$178.33	6
Montana	179	$218.78	$160.46	6
Wyoming	176	$247.42	$174.46	4
New Hampshire	132	$195.66	$127.18	2
North Dakota	71	$224.51	$177.16	2
Rhode Island	56	$261.23	$202.64	2
Puerto Rico	42	$268.20	$199.39	2

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.