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CPT 99392: Preventive Medicine Periodic Reevaluation and Management
CPT code 99392 denotes a preventive medicine reevaluation and management visit for patients without acute complaints who require routine periodic health examinations. Nationally, preventive visits are central to childhood immunization schedules, developmental surveillance, chronic disease prevention, and population health strategies, making 99392 an important code for tracking preventive care delivery and quality metrics. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical purpose of the code, typical settings where the service is delivered, common associated diagnoses used to report preventive encounters, and related service codes that may be billed alongside preventive services. The publication highlights billing context such as when to report preventive visits versus problem-focused visits, interactions with screening services (for example, vision and hearing screens), and common coding scenarios encountered in outpatient primary care and pediatric practices. It also summarizes payer coverage scope and provides benchmarking and policy-relevant context for how preventive medicine visits fit into national efforts to improve preventive care rates and reduce downstream morbidity. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 99392 describes a preventive medicine reevaluation and management service for patients who do not require immediate medical attention but need a periodic health checkup. These visits encompass routine well-child and well-person examinations where the clinician performs a comprehensive review of systems and a thorough past, family, and social history, assesses age- and gender-related risk factors, and may order diagnostic or laboratory tests and administer immunizations as part of preventive care.
Service type: Preventive medicine — periodic reevaluation and management
Typical site of service: Outpatient clinic or office setting, including pediatric or primary care practices where routine well visits and annual physical examinations are provided.
National Reimbursement Benchmarks
Commercial reimbursement for CPT 99392 clusters around BUCA’s average commercial rate of $105.20, with notable dispersion among individual payers. UnitedHealth Group and Cigna sit above BUCA on mean and median values, while Blue Cross Blue Shield and Aetna show wider spread between lower and higher payments. BUCA’s distribution (P25 $71.20 to P75 $130.80) positions it near the market center.
Measuring interquartile dispersion (P75 minus P25) highlights differences in rate consistency: Blue Cross Blue Shield has the tightest IQR at $40.70, indicating relatively consistent midrange payments; Aetna’s IQR is $96.10 and Cigna’s is $74.10, both showing broader mid-market variability. UnitedHealth Group’s IQR of $81.90 also reflects substantial spread, suggesting greater mid-tier rate variation compared with Blue Cross Blue Shield.