CPT 99224 is a temporary, administrative and miscellaneous code that the 2026 Medicare Physician Fee Schedule does not price. Commercial payers may still reimburse it.
Medicare rates for this code are not published in the 2026 physician fee schedule.
A Medicare rate is not one number — it is several, combined. Here is what each part of the CPT 99224 rate above actually means.
Not every billing code is on the Medicare Physician Fee Schedule. Many HCPCS codes — behavioral health, DMEPOS, and drugs billed under J or Q codes — are priced under a separate CMS fee schedule, paid at a state Medicaid rate, or reimbursed only by commercial payers.
Commercial payers negotiate their own rate for codes Medicare doesn't price, independent of any federal fee schedule. See what payers negotiate for 99224.
This page reflects the 2026-01-01 CMS Physician Fee Schedule. Want the full story behind why this data is public at all — the rules, the deadlines, the penalties? Read the price transparency law guide.
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.