Rate benchmarks · UnitedHealthcare · CPT 99214 · Tennessee

What does UnitedHealthcare pay for 99214 in Tennessee?

Office o/p est mod 30 min

The median UnitedHealthcare office rate for CPT 99214 in Tennessee is $110.43 — about 87% of the Medicare allowed amount ($127.36). These benchmarks come from UnitedHealthcare's federally required price-transparency disclosures, scoped to provider groups practicing in Tennessee and normalized to clean, comparable, per-procedure rates.

Last verified July 2026 · 2,066 contracting groups in Tennessee · national benchmark →

How to read these numbers

A negotiated rate is the contract-specific allowed amount UnitedHealthcare has agreed to pay an in-network practice for a service — the number that actually lands on your remittance, not the billed charge. Since July 2022, the federal Transparency in Coverage rule has required every commercial insurer to publish every negotiated rate, for every provider group, in public machine-readable files (MRFs). The figures on this page are aggregated directly from UnitedHealthcare's own filings for CPT 99214, restricted to contracting groups whose clinicians practice in Tennessee.

The median ($110.43 in the office setting) is the middle Tennessee contract: half of UnitedHealthcare's in-state contracting groups are paid more, half less. The 25th–75th percentile range ($92.78–$135.61) is where the middle half of Tennessee contracts sit — the practical negotiating band for a practice in this market. Below the 25th percentile means most comparable Tennessee groups signed better terms for the identical service, and the dollars between your rate and the median are recoverable on every single visit.

% of Medicare converts each commercial rate to a multiple of the Medicare Physician Fee Schedule allowed amount (CY 2026). Payer contracts are very often written this way — “105% of the current Medicare fee schedule” — because it prices thousands of codes with one number and updates automatically each year. Knowing that UnitedHealthcare's Tennessee median for 99214 is roughly 87% of Medicare lets you compare offers across codes, payers, and years on one common scale.

Why benchmark 99214 at the state level?

Commercial rates are local. Wage indexes, health-system consolidation, and how much UnitedHealthcare needs a given network all vary by market, so a national median can over- or under-state what comparable Tennessee practices actually sign. The table above is computed only from groups whose clinicians practice in Tennessee — the peers a Tennessee practice will actually be compared with at the negotiating table. For the widest sample (and codes or settings that are thin at state level), use the national UnitedHealthcare 99214 benchmark.

Methodology & data freshness

• Source. UnitedHealthcare's public Transparency in Coverage machine-readable files — the insurer's own federally mandated disclosure of every in-network negotiated rate. No claims data, surveys, or estimates.
• State scope. A contracting group counts as Tennessee when the majority of its clinicians (by NPI registration) practice in Tennessee, so border-town satellite offices don't eject a group and out-of-state systems don't dilute the sample. Benchmarks for 99214 span 2,066 contracting groups in Tennessee, collapsed to one representative professional rate per group.
• Cleaning. Payment-reducing modifier lines (assistant-surgeon, reduced-service, and similar) are excluded, and rates implausibly far from the Medicare benchmark are dropped before percentiles are computed. Settings with too few Tennessee groups for a defensible median are omitted rather than published thin.
• Freshness. Insurers republish these files monthly; benchmarks are rebuilt on the same cadence and this page revalidates daily. Data refreshed July 2026. Medicare comparisons use the CY 2026 Medicare Physician Fee Schedule.

UnitedHealthcare 99214 in Tennessee — FAQ

Is $110.43 a good UnitedHealthcare rate for 99214 in Tennessee?

$110.43 is the median — the middle contract — across 1,088 UnitedHealthcare contracting groups in Tennessee. If your allowed amount for 99214 is below the 25th percentile ($92.78), most comparable Tennessee groups negotiated more than you did, and that gap is usually the strongest line in a renegotiation request. At or above the 75th percentile ($135.61), you are already ahead of most of the Tennessee market on this code. Compare your own rate free →

How does the Tennessee rate for 99214 compare with UnitedHealthcare's national rate?

Commercial rates vary by market: local wage levels, health-system consolidation, and how competitive UnitedHealthcare's network is in Tennessee all move the negotiated amount. That is why a Tennessee practice should benchmark against Tennessee contracts — the $92.78–$135.61 middle-half band on this page — before reaching for a national figure. See the national benchmark →

Why does UnitedHealthcare pay different Tennessee practices different amounts for 99214?

Commercial rates are set contract by contract, not from a single public fee schedule. Two Tennessee practices on the same street can be paid very differently for 99214 depending on group size, specialty mix, negotiating leverage, and how long it has been since anyone re-opened the agreement. That is why the middle half of UnitedHealthcare's Tennessee contracts alone spans $92.78 to $135.61 — a $43 spread on a single visit.

Can I negotiate my UnitedHealthcare rate for 99214 in Tennessee?

Usually, yes. Most commercial agreements allow a renegotiation request or renew on an anniversary date, and payers do adjust rates for practices that arrive with data. Showing that your 99214 rate sits below the Tennessee median of $110.43 across 1,088 in-state contracting groups is a far stronger opening than asking for a flat percentage increase. Read the renegotiation guide →

Why are the office and facility rates for 99214 different?

The professional rate depends on site of service. When the visit happens in a practice-owned office, UnitedHealthcare's Tennessee median is $110.43; when it happens in a hospital outpatient department or ambulatory surgery center — where the facility bills its own separate fee — the professional payment drops to a median of $80.91, because the practice is no longer covering the overhead. Benchmark against the setting where you actually deliver the service.

How current is this UnitedHealthcare Tennessee rate data?

UnitedHealthcare republishes its machine-readable rate files monthly under the federal Transparency in Coverage rule, and these benchmarks are rebuilt on the same cadence. This page was last verified July 2026, with Medicare comparisons drawn from the CY 2026 Medicare Physician Fee Schedule.

Source: UnitedHealthcare Transparency in Coverage machine-readable files, refreshed monthly; last verified July 2026. Aggregate benchmarks over 2,066 contracting groups in Tennessee; no individual practice or contract is identified. EarnestMD is independent and not affiliated with any insurer. This page is informational and is not legal or payer-contracting advice.