CPT 99384: Well-Adolescent Visit, New Patient (Ages 12–17)
Commercial payers pay $131 on average nationally for this procedure.
CPT code 99384 describes a comprehensive preventive medicine, new patient well-adolescent visit for ages 12–17, documenting history, physical examination, and anticipatory guidance; service type: preventive medicine new patient visit; typical site of service: outpatient clinic or office-based setting for adolescent primary care.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 99384 centers around BUCA’s average commercial benchmark of $130.8, with meaningful variation among major payers. UnitedHealth Group posts the highest central tendency (median $164.2) and largest upper tail (P90 $293.2), while Cigna and Aetna also show elevated medians ($136.5 and $122.4 respectively). Blue Cross Blue Shield’s median is lower ($104.9), and BUCA aligns near the middle at $120.4 (median). Aetna and Cigna have notable upper extremes (max $346 and $403.4) while UnitedHealth Group’s max is $415.3, illustrating substantial upside for some contracts.
Dispersion measured by the interquartile spread (P75−P25) highlights contrasts: UnitedHealth Group is the widest with a spread of $104 ($228.6−$123.8), followed by Cigna at $100.9 ($197.6−$97.1). Blue Cross Blue Shield is the tightest with a spread of $18.7 ($129.7−$82.0). Aetna’s spread is $100.5 ($188.3−$85.8) and BUCA’s spread is $54.2 ($161.9−$90.7), indicating moderate variability around the BUCA average.