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Home Visit, New Patient, Moderate Complexity

California rates for HCPCS 99343

A first visit by a doctor or other qualified provider to a patient in the patient's own home, at a moderate level of complexity. It involves a detailed history and examination and decision-making about a problem of moderate severity, for someone the provider has not seen before.

Rates data updated July 2026.

How much does Home Visit, New Patient, Moderate Complexity cost?

$525

Typical physician fee. In California, July 2026.

Insurers have agreed to pay about $525 for this service. Most negotiated rates run $525 to $525.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $525 · 10th to 90th $525 to $525Professionalmedian $155 · 10th to 90th $95 to $339
$100$200$500facility $525professional $155

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$251.19
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$107.15
Typical High
$151.36

Where California sits

The same service costs 17.4 times more in Missouri than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

California· 4th of 36

$525

MO $525SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.