CPT 99385 is an annual preventive exam, the "physical", for a new patient aged 18 to 39: history, examination, counseling and ordering of age-appropriate screening. Under the Affordable Care Act, insured patients usually pay nothing for it. The price on this page is for the uninsured and for plans outside those rules.
What the price covers
The visit itself. Laboratory tests, vaccines and any problem-focused work done in the same visit are separate. If you raise a new problem during a preventive visit, many practices bill a second, problem-oriented visit code on top, which is legal and a frequent surprise on bills.
Why prices vary
Hospital-owned clinics may add a facility fee; independent practices usually do not. Cash prices for a physical range from around $100 to several hundred dollars.
Questions to ask
- What is the self-pay price for 99385, and is there a facility fee?
- Which labs or vaccines will be added, and what do they cost?
- If I mention a specific problem, will a second visit code be billed?