CPT 99347 Evaluation & Management

How Much Does Home/res Vst Established Straightforward Mdm 20 Cost?

Also known as: Home/res vst est sf mdm 20 (CPT 99347)

A follow-up house call for an established patient with a straightforward medical issue.

Home/res Vst Established Straightforward Mdm 20 (CPT 99347) costs $46 at Medicare rates.

The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.

Medicare (Facility)
$46
CMS PFS 2026 national rate

Patient Guide: Home/res Vst Established Straightforward Mdm 20

What you need to know before your appointment

What to Expect

Your doctor will visit your home for a brief check-up, review your condition, and make minor care adjustments.

How Long Does It Take?

20 minutes

Common Reasons Doctors Order This

Routine follow-up for stable homebound patient

How to Prepare

Have your medications ready for review. Write down any new symptoms or concerns.

Procedures Commonly Done Together

These procedures are frequently performed alongside Home/res vst est sf mdm 20

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How to Reduce Your Cost for Home/res vst est sf mdm 20

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.90
Work RVU
0.44
Practice Expense RVU
0.04
Malpractice RVU
1.38
Total RVU

Payment = Total RVU (1.38) x CF ($33.40) = $46

Frequently Asked Questions

How much does Home/res vst est sf mdm 20 cost?

The Medicare facility rate for Home/res vst est sf mdm 20 is $46. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Home/res vst est sf mdm 20 cost without insurance?

Without insurance, the cost of Home/res vst est sf mdm 20 can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Home/res vst est sf mdm 20?

Most commercial health insurance plans and Medicare cover Home/res vst est sf mdm 20 when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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