How Much Does CPT Code 99214 Cost?

TL;DR:
CPT code 99214 is used for a moderate-complexity office visit with an established patient.
Typical out-of-pocket costs range from $120 to $300, depending on the provider, insurance, and facility fees.

🩺 What is CPT Code 99214?

• CPT Code: 99214
• Description: Office or other outpatient visit for the evaluation and management of an established patient.
• Complexity Level: Moderate (30-39 minutes face-to-face with the patient).
• Typical Use: Managing chronic conditions, multiple health issues, or more in-depth consultations.

💵 How Much Does CPT Code 99214 Cost?

⚠️ Facility fees can easily tack on another $50-$100 if you’re in a hospital setting.

🏥 Why Is CPT 99214 More Expensive Than 99213?

• Longer Visit Time: Typically 30+ minutes.
• Higher Complexity: Managing multiple conditions, medication adjustments, coordination of care.
• Documentation Requirements: More detailed charts, care plans.

It’s not just a money grab—but always verify if the complexity justifies the upcharge.

📊 Real Example: My CPT 99214 Bill Breakdown

I had a visit involving diabetes management + medication adjustment—classic 99214 scenario.
Here’s how it hit my wallet:

If I had asked for a cash pay rate, the office offered a $180 flat fee.

🤔 When Will You See CPT 99214 On Your Bill?

Expect CPT 99214 charges for:

• Chronic condition management (diabetes, hypertension, etc.)
• Visits involving multiple medical issues
• Mental health management visits
• Complex medication reviews or care coordination

🔍 CPT 99213 vs. 99214: Quick Comparison

🧰 Helpful Tools

• ✅ Use Our CPT Code Cost Checker Tool