Self-pay Pricing

We welcome self-pay families (without insurance) with easy to understand pricing.
Cash, Visa, Mastercard are accepted

New Patient

Sick Visit: Illness Complexity

- Low: $120
- Moderate: $160
- High: $200

Well Visit: Age

- 0-4 years: $160
- 5+ years: $200

Established Patient

Sick Visit: Illness Complexity

- Low: $100
- Moderate: $140
- High: $180

Well Visit: Age

- 0-4 years: $140
- 5+ years: $180

Frequently Asked Questions (FAQs)

What are trusted sources to find out more about CPT codes and billing. ?

Here are some trusted sources on finding out about CPT codes

AAP (Healthychildren.org): How Your Pediatrician is Paid: Coding Information for Parents
Centers for Medicare & Medicaid Services CMS): List of CPT/HCPCS Codes

What are CMS descriptions of common CPT Codes - Age related?

Here is how the Centers for Medicare & Medicaid Services (CMS) officially defines common CPT codes

99391: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history examination counseling anticipatory guidance risk factor reduction interventions and the ordering of laboratory diagnostic procedures established patient infant (age younger than 1 year)
99392: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history examination counseling anticipatory guidance risk factor reduction interventions and the ordering of laboratory diagnostic procedures established patient early childhood (age 1 through 4 years)
99393: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history examination counseling anticipatory guidance risk factor reduction interventions and the ordering of laboratory diagnostic procedures established patient late childhood (age 5 through 11 years)
99394: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history examination counseling anticipatory guidance risk factor reduction interventions and the ordering of laboratory diagnostic procedures established patient adolescent (age 12 through 17 years)
99395: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history examination counseling anticipatory guidance risk factor reduction interventions and the ordering of laboratory diagnostic procedures established patient 18-39 years

What are CMS descriptions of common CPT Codes - Illness Complexity?

Here is how the Centers for Medicare & Medicaid Services (CMS) officially defines common CPT codes

Low Complexity Codes:

99211: Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional. Usually the presenting problem(s) are minimal. Typically 5 minutes are spent performing or supervising these services.
99212: Office or other outpatient visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: A problem focused history A problem focused examination Straightforward medical decision making. Counseling andor coordination of care with other physicians other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the patients andor familys needs. Usually the presenting problem(s) are self limited or minor. Typically 10 minutes are spent face-to-face with the patient andor family.

Medium Complexity:

99213: Office or other outpatient visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: An expanded problem focused history An expanded problem focused examination Medical decision making of low complexity. Counseling and coordination of care with other physicians other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the patients andor familys needs. Usually the presenting problem(s) are of low to moderate severity. Typically 15 minutes are spent face-to-face with the patient and or family.
99214: Office or other outpatient visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: A detailed history A detailed examination Medical decision making of moderate complexity. Counseling andor coordination of care with other physicians other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the patients andor familys needs. Usually the presenting problem(s) are of moderate to high severity. Typically 25 minutes are spent face-to-face with the patient andor family.

High Complexity:

99215: Office or other outpatient visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: A comprehensive history A comprehensive examination Medical decision making of high complexity. Counseling andor coordination of care with other physicians other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the patients andor familys needs. Usually the presenting problem(s) are of moderate to high severity. Typically 40 minutes are spent face-to-face with the patient andor family.

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