# CPT 99252: Inpatient or observation consultation, straightforward to low medical decision making

Medicare CPT 99252 pays $70.14 in a non-facility setting and $70.14 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $66.40 in Arkansas to $95.12 in Alaska, a 43% spread.

Web page: https://www.med-reveal.com/rates/99252-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, Infectious Disease, Pulmonary Disease

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $70.14 |
| National facility | $70.14 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $95.12 | $95.12 |
| District of Columbia | $76.24 | $76.24 |
| New York | $75.49 | $75.49 |
| New Jersey | $75.13 | $75.13 |
| California | $73.90 | $73.90 |
| Washington | $73.59 | $73.59 |
| Massachusetts | $73.29 | $73.29 |
| Connecticut | $73.04 | $73.04 |
| Florida | $72.73 | $72.73 |
| Illinois | $72.16 | $72.16 |
| Maryland | $71.74 | $71.74 |
| Hawaii | $71.40 | $71.40 |
| Rhode Island | $71.38 | $71.38 |
| Colorado | $71.27 | $71.27 |
| Oregon | $70.74 | $70.74 |
| New Hampshire | $70.52 | $70.52 |
| Pennsylvania | $70.42 | $70.42 |
| Puerto Rico | $70.29 | $70.29 |
| Virgin Islands | $70.29 | $70.29 |
| Michigan | $70.18 | $70.18 |
| Montana | $70.14 | $70.14 |
| Texas | $69.96 | $69.96 |
| Georgia | $69.94 | $69.94 |
| Delaware | $69.91 | $69.91 |
| Nevada | $69.71 | $69.71 |
| Wyoming | $69.45 | $69.45 |
| New Mexico | $69.24 | $69.24 |
| Arizona | $69.22 | $69.22 |
| Virginia | $69.06 | $69.06 |
| West Virginia | $69.02 | $69.02 |
| Utah | $68.83 | $68.83 |
| Louisiana | $68.76 | $68.76 |
| Minnesota | $68.76 | $68.76 |
| Missouri | $68.67 | $68.67 |
| Ohio | $68.65 | $68.65 |
| Vermont | $68.65 | $68.65 |
| North Dakota | $68.55 | $68.55 |
| South Carolina | $68.42 | $68.42 |
| Maine | $68.37 | $68.37 |
| South Dakota | $68.37 | $68.37 |
| North Carolina | $68.01 | $68.01 |
| Kentucky | $67.99 | $67.99 |
| Oklahoma | $67.69 | $67.69 |
| Wisconsin | $67.56 | $67.56 |
| Indiana | $67.50 | $67.50 |
| Idaho | $67.34 | $67.34 |
| Tennessee | $67.32 | $67.32 |
| Kansas | $67.15 | $67.15 |
| Nebraska | $67.14 | $67.14 |
| Iowa | $67.05 | $67.05 |
| Mississippi | $67.03 | $67.03 |
| Alabama | $66.81 | $66.81 |
| Arkansas | $66.40 | $66.40 |

## Related codes

- 99242: Office or outpatient consultation, low medical decision making — https://www.med-reveal.com/rates/99242-cpt-fee-schedule
- 99243: Office or outpatient consultation, moderate medical decision making (lower) — https://www.med-reveal.com/rates/99243-cpt-fee-schedule
- 99244: Office or outpatient consultation, moderate medical decision making — https://www.med-reveal.com/rates/99244-cpt-fee-schedule
- 99245: Office or outpatient consultation, high medical decision making — https://www.med-reveal.com/rates/99245-cpt-fee-schedule
- 99253: Inpatient or observation consultation, low medical decision making — https://www.med-reveal.com/rates/99253-cpt-fee-schedule
- 99254: Inpatient or observation consultation, moderate medical decision making — https://www.med-reveal.com/rates/99254-cpt-fee-schedule
- 99255: Inpatient or observation consultation, high medical decision making — https://www.med-reveal.com/rates/99255-cpt-fee-schedule

Commercial negotiated rates for 99252 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules