CPT 99387: Initial Preventive Medicine Visit, Age 65 or Older
Commercial payers pay $179 on average nationally for this procedure.
CPT code 99387 describes a comprehensive initial preventive medicine visit for an individual 65 years or older, representing a well‑patient preventive evaluation focused on age‑appropriate history, preventive counseling, risk assessment, and development of a preventive plan; the service type is a comprehensive preventive medicine evaluation typically performed in an office or clinic outpatient setting for an older adult patient.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 99387 centers on BUCA’s average commercial rate of $179.00, with notable variation across major national payers. UnitedHealth Group posts the highest central tendency with a median of $205.50 and a mean of $227.90, while Blue Cross Blue Shield centers lower with a median of $151.20 and a mean of $168.10; Aetna and Cigna fall between those markers with means of $153.50 and $188.20, respectively. BUCA’s mean sits near the middle of this distribution, signaling a moderate commercial benchmark relative to these national payers.
Dispersion measured by the IQR (P75 minus P25) highlights where rates are tightest or widest: Blue Cross Blue Shield has the tightest spread at $66.90 (P75 $194.80 minus P25 $127.90), while UnitedHealth Group is the widest at $128.80 (P75 $282.90 minus P25 $154.10). Aetna’s IQR is $100.50, Cigna’s is $123.50, and BUCA’s IQR is $92.30, indicating materially greater variability among UnitedHealth Group and Cigna than among Blue Cross Blue Shield and BUCA.