CPT 99382: Initial Well-Child Visit, Age 1–4 Years
Commercial payers pay $122 on average nationally for this procedure.
CPT code 99382 describes a comprehensive preventive medicine visit for a new pediatric patient aged 1 through 4 years, typically performed as a well-child office visit that includes history, physical examination, developmental and behavioral assessment, anticipatory guidance, and preventive counseling; the service is a preventive pediatric evaluation usually delivered in an office or clinic setting for a child meeting the definition of a new patient.
For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.
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National Reimbursement Benchmarks
National commercial rates for CPT 99382 cluster around the BUCA average of $121.70, with payers showing meaningful variation around that level. UnitedHealth Group posts the highest central tendency (median $140) and a mean of $156, while Cigna and Blue Cross Blue Shield have medians of $115.20 and $102.20 with means of $128.50 and $111.20 respectively. Aetna’s mean is $111.80 and BUCA’s mean is $121.70. These figures place BUCA near the middle of the commercial spectrum rather than at an extreme. Dispersion measured by the interquartile range (P75–P25) is widest for Cigna at $84.90 (P75 $164.80 minus P25 $80.90) and UnitedHealth Group at $88.50 (P75 $194.00 minus P25 $105.50), indicating larger variability in commercial contract levels. Blue Cross Blue Shield and BUCA show tighter spreads: BCBS IQR is $42.90 (P75 $130.80 minus P25 $84.90) and BUCA IQR is $61.20 (P75 $150.00 minus P25 $84.80), while Aetna’s IQR is $61.10 (P75 $148.80 minus P25 $67.70), reflecting relatively moderate dispersion.