CPT 99214 · New Jersey
Horizon BCBS New Jersey 99214 rate: what practices are paid.
Horizon Blue Cross Blue Shield of New Jersey publishes the rate it negotiated with each practice, every month, by NPI. In its September 2026 files, the middle rate for 99214 (office visit, established patient, 30–39 min) was $107.66, and half of provider groups fell between $107.66 and $123.49. Yours may differ.
Horizon BCBS New Jersey contracts with practices in New Jersey. These figures are across the provider groups in its own files.
The payer’s published negotiated rate for your NPI, for the six codes your specialty bills most. For a primary care practice:
| Code | Visit | Negotiated rate |
|---|---|---|
| 99213 | Office visit, established patient, 20–29 min | — |
| 99214 | Office visit, established patient, 30–39 min | — |
| 99215 | Office visit, established patient, 40–54 min | — |
| 99203 | Office visit, new patient, 30–44 min | — |
| 99204 | Office visit, new patient, 45–59 min | — |
| 99212 | Office visit, established patient, 10–19 min | — |
Every figure comes from the payer’s own file, with the network and file date it was published under. We never invent a benchmark.
From Horizon BCBS New Jersey’s September 2026 files
99214: office visit, 30–39 min.
The rate in the middle of the provider groups that carry one rate for 99214.
At least a quarter of the provider groups carry exactly $107.66, which is why the middle rate sits at one end of the middle half.
A group in two networks counts once in each.
Last checked against Horizon BCBS New Jersey’s postings Sep 21, 2026.
26 more provider groups carry more than one rate for 99214 in the same file and are left out rather than averaged. Source: Horizon Blue Cross Blue Shield of New Jersey’s in-network rate files under the federal Transparency in Coverage rule, September 2026.
How the rate is chosen
The same rule as your own lookup.
For each provider group we take the in-office rate (place of service 11, or a rate published for any setting), professional billing only, and the plain code before any modifier. A group whose file lists several different rates for the code isn’t averaged in. 99214 is billed mostly by primary care and specialist offices. How we pick a rate, code by code →
99214 at other payers
The same code, payer by payer.
| Payer | Middle rate | Middle half | Files |
|---|---|---|---|
| UnitedHealthcare | $115.27 | $96.15 – $147.69 | September 2026, nationwide |
| Aetna | $119.54 | $89.71 – $166.75 | September 2026, nationwide |
| Cigna | $131.54 | $102.07 – $179.60 | September 2026, nationwide |
| BCBS Texas | $90.75 | $64.83 – $100.87 | September 2026 |
| Florida Blue | $98.18 | $94.51 – $112.20 | September 2026 |
| Horizon BCBS New Jersey | $107.66 | $107.66 – $123.49 | September 2026 |
| BCBS Mississippi | $130.62 | $115.00 – $130.62 | September 2026 |
In these files, Horizon BCBS New Jersey’s middle rate for 99214 is the 3rd lowest of the 7 payers here (highest: Cigna, $131.54). It is $34.49 more than Horizon BCBS New Jersey’s middle rate for 99213 ($73.17). All seven side by side: 99214 reimbursement rate 2026.
Payers with a monthly read of their files. At our other payers a lookup reads your own rate straight from the file, so there’s no typical figure to compare.
Other codes at Horizon BCBS New Jersey
Horizon BCBS New Jersey’s everyday codes, September 2026.
| Code | Visit | Middle rate | Middle half |
|---|---|---|---|
| 99212 | Office visit, established patient, 10–19 min | $49.14 | $49.14 – $54.46 |
| 99213 | Office visit, established patient, 20–29 min | $73.17 | $73.17 – $83.93 |
| 99214 | Office visit, established patient, 30–39 min | $107.66 | $107.66 – $123.49 |
| 99215 | Office visit, established patient, 40–54 min | $143.69 | $143.69 – $164.81 |
| 99203 | Office visit, new patient, 30–44 min | $108.30 | $108.30 – $121.93 |
| 99204 | Office visit, new patient, 45–59 min | $165.18 | $165.18 – $188.47 |
| 90791 | Psychiatric diagnostic evaluation | $141.41 | $132.96 – $156.42 |
| 90834 | Psychotherapy, 45 min | $91.54 | $86.16 – $101.36 |
| 90837 | Psychotherapy, 60 min | $137.26 | $128.95 – $151.70 |
Your own rate
Is Horizon BCBS New Jersey paying you this?
The figure that matters is the one Horizon BCBS New Jersey published for your practice. Look up your own Horizon BCBS New Jersey rates free: your NPI, the codes your specialty bills most, by email. On a paid plan, Horizon BCBS New Jersey sits next to your other payers for the codes you bill, and the underpayment check shows any code allowed below it.
Questions
About Horizon BCBS New Jersey’s 99214 rate.
How much does Horizon BCBS New Jersey pay for CPT 99214?
In Horizon BCBS New Jersey’s September 2026 files, the middle in-office rate for 99214 (Office visit, established patient, 30–39 min) was $107.66, and half of the provider groups were paid between $107.66 and $123.49. Your own contract can sit anywhere in or outside that range.
Where does this number come from?
From Horizon Blue Cross Blue Shield of New Jersey’s own in-network rate files, published under the federal Transparency in Coverage rule. These figures are from its September 2026 files (23 files). We take each provider group’s rate for 99214 by the same rule a lookup uses and report the middle and the middle half. Nothing is estimated.
Why is my rate different?
Horizon BCBS New Jersey negotiates with each practice separately, so contracts differ. The network matters too (one practice can hold different rates in different Horizon BCBS New Jersey products), and so do setting and modifiers. These figures are in-office, professional rates for the plain code.
How do I find my own Horizon BCBS New Jersey rate for 99214?
Enter your NPI in the free lookup on this page. It reads Horizon BCBS New Jersey’s file for the rate published for your practice, for the codes your specialty bills most, and emails you a copy.
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