# CPT 99359: Prolng E/m Before&/after Dir Care Ea 30 Minutes

Medicare CPT 99359 pays $39.08 in a non-facility setting and $32.40 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $36.53 in Arkansas to $51.66 in Alaska, a 41% spread.

Web page: https://www.med-reveal.com/rates/99359-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Emergency Medicine, Evaluation, Hematology & Oncology, Optometrist, Psychiatry & Neurology, Psychoanalyst, Sleep Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $39.08 |
| National facility | $32.40 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $51.66 | $44.54 |
| District of Columbia | $42.82 | $34.95 |
| New York | $42.30 | $34.84 |
| New Jersey | $42.07 | $34.55 |
| California | $41.48 | $33.57 |
| Washington | $41.25 | $33.63 |
| Massachusetts | $41.06 | $33.55 |
| Connecticut | $40.88 | $33.69 |
| Florida | $40.70 | $34.00 |
| Illinois | $40.27 | $33.82 |
| Hawaii | $40.07 | $32.47 |
| Maryland | $40.06 | $33.10 |
| Colorado | $39.80 | $32.70 |
| Rhode Island | $39.78 | $32.88 |
| Oregon | $39.48 | $32.44 |
| New Hampshire | $39.38 | $32.42 |
| Puerto Rico | $39.19 | $32.44 |
| Virgin Islands | $39.19 | $32.44 |
| Pennsylvania | $39.17 | $32.62 |
| Montana | $39.08 | $32.40 |
| Michigan | $39.00 | $32.74 |
| Texas | $38.91 | $32.33 |
| Delaware | $38.89 | $32.29 |
| Georgia | $38.88 | $32.50 |
| Nevada | $38.81 | $32.13 |
| Wyoming | $38.64 | $31.96 |
| Arizona | $38.46 | $31.98 |
| New Mexico | $38.39 | $32.26 |
| Virginia | $38.38 | $31.81 |
| Minnesota | $38.26 | $31.39 |
| West Virginia | $38.18 | $32.37 |
| Utah | $38.17 | $31.89 |
| Vermont | $38.13 | $31.52 |
| Louisiana | $38.09 | $31.99 |
| North Dakota | $38.09 | $31.41 |
| Missouri | $38.04 | $31.90 |
| Ohio | $38.02 | $31.92 |
| South Dakota | $37.97 | $31.29 |
| Maine | $37.91 | $31.52 |
| South Carolina | $37.89 | $31.72 |
| North Carolina | $37.65 | $31.42 |
| Kentucky | $37.57 | $31.63 |
| Wisconsin | $37.40 | $31.00 |
| Oklahoma | $37.38 | $31.42 |
| Indiana | $37.32 | $31.13 |
| Idaho | $37.21 | $31.06 |
| Tennessee | $37.18 | $31.11 |
| Nebraska | $37.09 | $30.92 |
| Kansas | $37.06 | $31.03 |
| Iowa | $37.02 | $30.91 |
| Mississippi | $36.93 | $31.17 |
| Alabama | $36.81 | $30.96 |
| Arkansas | $36.53 | $30.79 |

## Related codes

- 99201: New Patient Office Visit: Coverage and Documentation Requirements — https://www.med-reveal.com/rates/99201-cpt-fee-schedule
- 99241: Office consultation for a new or established patient that requires these three key components: a problem-focused history; a problem-focused examination; and straightforward medical decision-making — https://www.med-reveal.com/rates/99241-cpt-fee-schedule
- 99251: Inpatient consultation for a new or established patient which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. — https://www.med-reveal.com/rates/99251-cpt-fee-schedule
- 99288: Phys/qhp Direction Emergency Medical Systems — https://www.med-reveal.com/rates/99288-cpt-fee-schedule
- 99354: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99354-cpt-fee-schedule
- 99355: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99355-cpt-fee-schedule
- 99358: Prolng E/m Svc Before&/after Dir Pt Care 1st Hr — https://www.med-reveal.com/rates/99358-cpt-fee-schedule
- 99360: Phys Standby Svc Prolng Phys Attn Ea 30 Minutes — https://www.med-reveal.com/rates/99360-cpt-fee-schedule

Commercial negotiated rates for 99359 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