CPT code 99382: Preventive visit, new patient, age 1-42026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99382 covers

99382 represents a comprehensive preventive evaluation for a new patient age 1 through 4. The visit centers on age-appropriate health history and examination, review of growth and development, screening as appropriate, and counseling such as nutrition, safety, and other anticipatory guidance. Pediatricians and family physicians commonly report it in office or outpatient settings when establishing preventive care for a young child.

Choose this code for the new-patient age band, not for an established patient or a child in another age range. Medicare lists the code as not covered (status N), so it has no Medicare payment under this code. The code represents the preventive evaluation, not vaccine products or their administration, which are reported separately when performed and applicable.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 99382 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99382 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 99382 rate is calculated

Each of 99382’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 99382

99382 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

99382 compared with similar codes

How to choose

99381Infant preventive visitNew patient, under 1 year

Both are new-patient preventive visits, but 99381 is for an infant younger than age 1; 99382 is for ages 1 through 4.

99383Child preventive visitNew patient, age 5–11

99383 is the new-patient preventive code for ages 5 through 11. Use 99382 for ages 1 through 4.

99392Well-child visitEstablished, age 1–4

The age range is the same, but 99392 is for an established patient; 99382 is for a new patient.

Codes related to 99382

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates