CPT 99342

Home/Res Visit New Patient Low Mdm 30 Minutes

CPT 99342 pays $78.83 in a non-facility setting and $78.83 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $74.68 in Arkansas to $106.72 in Alaska, a 43% spread.

National non-facility rate

$78.83

Office and other outpatient settings

Facility rate
$78.83

Hospital and ASC settings

Highest state
$106.72

Alaska

Lowest state
$74.68

Arkansas · 43% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $78.83
CPT 99342 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $78.83, national facility $78.83.
StateRate compared visuallyNon-facilityFacility
Alaska
$106.72$106.72
District of Columbia
$85.87$85.87
New York
$84.75$84.75
New Jersey
$84.55$84.55
California
$83.65$83.65
Washington
$83.06$83.06
Massachusetts
$82.67$82.67
Connecticut
$82.07$82.07
Florida
$81.11$81.11
Hawaii
$80.77$80.77
Maryland
$80.63$80.63
Illinois
$80.43$80.43
Colorado
$80.34$80.34
Rhode Island
$80.33$80.33
Oregon
$79.76$79.76
New Hampshire
$79.41$79.41
Pennsylvania
$79.05$79.05
Puerto Rico
$79.03$79.03
Virgin Islands
$79.03$79.03
Montana
$78.82$78.82
Texas
$78.63$78.63
Delaware
$78.61$78.61
Michigan
$78.47$78.47
Nevada
$78.46$78.46
Georgia
$78.38$78.38
Wyoming
$78.22$78.22
Arizona
$77.83$77.83
Minnesota
$77.80$77.80
Virginia
$77.78$77.78
New Mexico
$77.52$77.52
Vermont
$77.46$77.46
North Dakota
$77.44$77.44
Utah
$77.31$77.31
South Dakota
$77.27$77.27
Louisiana
$77.08$77.08
Missouri
$77.03$77.03
West Virginia
$77.03$77.03
Maine
$77.00$77.00
Ohio
$76.99$76.99
South Carolina
$76.85$76.85
North Carolina
$76.55$76.55
Wisconsin
$76.31$76.31
Kentucky
$76.25$76.25
Indiana
$76.06$76.06
Oklahoma
$76.02$76.02
Idaho
$75.88$75.88
Tennessee
$75.80$75.80
Nebraska
$75.73$75.73
Kansas
$75.61$75.61
Iowa
$75.60$75.60
Mississippi
$75.24$75.24
Alabama
$75.14$75.14
Arkansas
$74.68$74.68

Billed by 1 specialties

Commercial rates for 99342

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates