What is the standard insurance baseline for CPT 99451?

The standard insurance baseline reimbursement rate is $34.94. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Telephone Internet or Electronic Health Record Assessment and Management with Written Report by Consulting Physician at Least 5 Minutes

CPT 99451Medical Service

Telephone Internet or Electronic Health Record Assessment and Management with Written Report by Consulting Physician at Least 5 Minutes

Q: What do doctors typically charge for Telephone Internet or Electronic Health Record Assessment and Management with Written Report by Consulting Physician at Least 5 Minutes?

The nationwide median physician charge for Telephone Internet or Electronic Health Record Assessment and Management with Written Report by Consulting Physician at Least 5 Minutes (CPT 99451) is $105.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes. Clinical pricing breakdown and utilization metrics across 990 practicing doctors nationwide.

$105.00

Peer Median Charge

Gross billed rate

$34.94

Standard Baseline

Customary allowable

3.0x

National Markup

Charge vs baseline

990

Active Physicians

Billing this code

Planning care or already received a bill for CPT 99451?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $105.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $34.94 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 99451 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"