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| CPT Code | Description | 2024 Payment Rate(Average Rate) | Change from 2023 | Purpose |
|---|---|---|---|---|
| 99490 | Chronic Care Management (CCM), at least 20 minutes | $66 | Stable | To manage chronic conditions through coordinated care. |
| 99484 | General Behavioral Health Integration (BHI) Care Management | $72.98 | Increased (from $48.00) | To integrate behavioral health services into primary care. |
| 99487 | Complex CCM, first hour | $175 | Stable | To provide comprehensive management for complex chronic conditions. |
| 99489 | Complex CCM, each additional 30 minutes | $87.5 | Stable | To bill for additional time spent managing complex chronic conditions. |
| G0511 | CCM services in Rural Health Clinics | $72.98 | Increased | To support chronic care management in rural settings. |
| 99304 | Nursing Facility Care, initial visit | $78.27 | Decreased (from $80.64) | To evaluate and manage patients in nursing facilities during initial visits. |
| 99305 | Nursing Facility Care, subsequent visit | $130.01 | Decreased (from $133.50) | To provide ongoing care and management for nursing facility residents. |
| 99306 | Nursing Facility Care, subsequent visit | $177.49 | Decreased (from $182.29) | To manage complex cases in nursing facilities during follow-up visits. |
| 99307 | Nursing Facility Care, subsequent visit | $39.3 | Decreased (from $39.64) | For routine follow-up visits in nursing facilities. |
| 99308 | Nursing Facility Care, subsequent visit | $72.7 | Decreased (from $74.54) | For additional follow-up care in nursing facilities. |
| 99309 | Nursing Facility Care, subsequent visit | $105.12 | Decreased (from $106.73) | To manage ongoing care needs for nursing facility patients. |
| 99310 | Nursing Facility Care, subsequent visit | $149.98 | Decreased (from $153.49) | For comprehensive management of complex cases in nursing facilities during follow-ups. |
| 99213 | Established patient office visit, low complexity | $82 | Stable | For routine office visits involving low-complexity cases. |
| 99214 | Established patient office visit, moderate complexity | $114 | Stable | For moderate complexity office visits requiring more extensive evaluation and management. |
| 99215 | Established patient office visit, high complexity | $157 | Stable | For high-complexity office visits that require significant medical decision-making and management time. |
| 90791 | Psychiatric diagnostic evaluation | $150 | Increased | To conduct comprehensive psychiatric evaluations for diagnosis and treatment planning. |
| 90792 | Psychiatric diagnostic evaluation with medical services | $175 | Increased | To provide psychiatric evaluations that include medical assessments and interventions. |
| 36415 | Collection of venous blood by venipuncture | $3.5 | Stable | For the collection of blood samples for laboratory testing purposes. |
| 92015 | Determination of refractive state of the eye | $Varies by locality | Stable | To assess a patient’s refractive error for corrective lenses. |
| 99205 | Office visit for new patients, high complexity | $226 | Increased | For comprehensive evaluation and management of new patients with complex conditions. |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified | $37.5 | Stable | To administer a corticosteroid injection for inflammation or pain relief. |
| 95111 | Professional services for allergen immunotherapy | $35 | Stable | To provide services related to allergen immunotherapy, including administration and monitoring. |
| 99490 | Chronic Care Management (CCM), at least 20 minutes | $66 | Stable | To manage chronic conditions through coordinated care over time. |
| 20610 | Arthrocentesis, aspiration and/or injection into a major joint or bursa | $80 | Stable | For the aspiration or injection of a major joint to relieve pain or obtain fluid for analysis. |
| 97140 | Manual therapy techniques | $45 | Increased | To provide hands-on treatment to improve musculoskeletal function and alleviate pain. |
| 90837 | Psychotherapy, 60 minutes with patient | $175 | Increased | For extended psychotherapy sessions focusing on mental health treatment. |
| 99495 | Transitional Care Management (TCM), within 14 days of discharge from inpatient stay | $165 | Stable | To facilitate follow-up care after hospital discharge to prevent readmission. |
| 95811 | Electroencephalogram (EEG) monitoring | $150 | Stable | For the recording of electrical activity in the brain to diagnose neurological conditions. |
| 77063 | Breast tomosynthesis, bilateral | $200 | New Code | For advanced breast imaging using 3D mammography technology for better detection of abnormalities. |
| 76882 | Ultrasound, transvaginal | $150 | Stable | To perform transvaginal ultrasound examinations for gynecological assessments. |
| 97112 | Neuromuscular reeducation | $75 | Stable | To improve movement patterns and coordination through therapeutic exercises. |
| 58571 | Laparoscopy, surgical; with removal of adnexa (salpingectomy) | $2000 | Decreased | For surgical procedures involving the removal of fallopian tubes via laparoscopic technique. |
| 96372 | Therapeutic, prophylactic, or diagnostic injection | $25 | Stable | For administering injections for therapeutic purposes in an outpatient setting. |
| 90846 | Family psychotherapy without the patient present | $120 | Increased | To provide therapy sessions focused on family dynamics without the patient being present. |
| 20610 | Arthrocentesis, aspiration, and/or injection into a major joint or bursa | $80 | Stable | To aspirate fluid or inject medication into a major joint for pain relief or diagnosis. |
| 29827 | Arthroscopy, knee, surgical; with meniscectomy, medial or lateral | $1500 | Stable | To perform a surgical procedure on the knee to remove a torn meniscus. |
| 29848 | Endoscopic carpal tunnel release | $1200 | Stable | To relieve pressure on the median nerve in the wrist through an endoscopic procedure. |
| 11760 | Repair of nail bed | $150 | Stable | To repair a damaged nail bed following injury. |
| 25215 | Carpectomy; all bones of the proximal row | $1800 | Stable | To remove all bones in the proximal row of the wrist for conditions like arthritis. |
| 64721 | Neuroplasty and/or transposition of median nerve at carpal tunnel | $2000 | Stable | To relieve carpal tunnel syndrome by addressing the median nerve. |
| 27447 | Total knee arthroplasty | $20000 | Increased | To perform total knee replacement surgery for severe arthritis or injury. |
| 28515 | Closed treatment of fracture, distal fibula | $600 | Stable | For non-surgical treatment of a distal fibula fracture. |
| 22836 | Anterior thoracic vertebral body tethering | $3500 | New Code | For tethering of vertebral bodies to correct spinal deformities. |
| 22837 | Anterior thoracic vertebral body tethering (8 or more segments) | $4500 | New Code | For extensive tethering involving multiple vertebral segments. |
| 99490 | Chronic Care Management (CCM), at least 20 minutes | $66 | Stable | To manage chronic conditions through coordinated care over time. |
| 96372 | Therapeutic injection | $25 | Stable | For administering injections for therapeutic purposes in an outpatient setting. |
| 97140 | Manual therapy techniques | $45 | Increased | To provide hands-on treatment to improve musculoskeletal function and alleviate pain. |
| 90837 | Psychotherapy, 60 minutes with patient | $175 | Increased | For extended psychotherapy sessions focusing on mental health treatment. |
| 99496 | Transitional Care Management (TCM), high complexity | $278.21 | Increased | To manage transitions from inpatient settings with high medical decision-making complexity. |
