This page lists typical fees for the practice. I encourage you to check fees elsewhere, but most practices do not post their fees. Some practices such as low-cost, walk-in clinics do, but you may not be comparing apples to apples. Walk-in clinics usually do not provide 24-7 call coverage for questions or problems you may have after the visit... or any guarantee of seeing a provider who knows you when you return. Walk-in clinics definitely have their place, but don't provide the ongoing relationship or 'medical home' that provide the best health outcomes for patients.
|
CPT |
Vist type and typical time spent |
Routine Charge* | Payment at time of service** |
| 99202 | New patient; 20 minutes |
95.00 | 55.00 (for up to 15 minutes) |
| 99203 | New patient; 30 minutes |
140.00 | 95.00 (for up to 30 minutes) |
| 99204 | New patient; 45 minutes |
215.00 | 135.00 (for up to 45 minutes) |
| 99205 | New patient; 60 minutes |
270.00 | 175.00 (for up to 60 minutes) |
| 99212 | Established patient; 10 minutes |
58.00 | 55.00 (for up to 15 minutes) |
| 99213 | Established patient; 15-24 minutes |
95.00 | 95.00 (for up to 30 minutes) |
| 99214 | Established patient; 25-39 minutes |
140.00 | 135.00 (for up to 45 minutes) |
| 99215 | Established patient; 40-60 minutes |
190.00 | 175.00 (for up to 60 minutes) |
| 99384 | New patient; Preventive exam age 12-17 | ||
| 99385 | New patient; Preventive exam age18-39 | ||
| 99386 | New patient; Preventive exam age 40-64 | 199.00 | |
| 99394 | Established patient; Preventive exam age 12-17 | ||
| 99395 | Established patient; Preventive exam age 18-29 | 140.00 | |
| 99396 | Established patient; Preventive exam age 40-64 (does not include cost of processing pap smear) |
154.00 | |
| Pap and breast exam only- 15 minute visit | 80.00 | ||
| Pap smear- charge for lab if paid to office | 50.00 | ||
| 98966 | Telephone Visit 5-10 minutes | 25.00 | 25.00 |
| 98967 | Telephone Visit 11-20 minutes | 40.00 | 40.00 |
| 98968 | Telephone Visit 21-30 minutes | 55.00 | 55.00 |
| 99444 | Online Email Visit | 42.00 | 42.00 |
| 90880 | Clinical Hypnosis | 150.00 | 150.00 or as negotiated |
* The routine charge is determined by local insurance allowable rates for these codes. Insurance generally reimburses a nurse practitioner 85% of the physician allowable rate. Thus, fees here are generally less expensive and if you have a percentage based co-insurance type plan, you share in the savings with your insurance company. Your insurance plan may 'allow' a somewhat lower rate than listed above and if I am a contracted provider with that plan, I accept their rate and do not "balance bill" you for the rest. I do not contract with all plans due to excessively low allowable rates that do not cover the overhead of doing business. Please note that the time examples are not set in stone, the visit level is also determined by complexity of the problem and associated risk (like chest pain is more complex and risky to evaluate than finger pain).
** If you make payment at the time of service and I do not bill insurance (per your request or because you are private pay), the fee is less than the routine charge. The reasons for the difference in rates are the many advantages of receiving payment at the time of service. Each insurance claim sent costs a few dollars (plus additional costs for re-submissions such as when your insurance information changed and we failed to update that before billing). Sending statements costs nearly a dollar each. It often takes 2-3 statements before payment is received in the office. The longer it takes to collect on the charge, the less likely the charge will be paid... These are some of the hidden costs a provider incurs in an insurance-based payment system. With payment at the time of service (for those not insured or not billing insurance) there is no"bad debt". And, the value of having payment upfront rather than waiting months for it is "priceless"!
Fees for 'Payment at the time of service' mean just that. If you cannot pay in full at the time of service, a payment plan can be arranged but the charge will be the higher routine charge.