# CPT 99396: Periodic preventive medicine visit, established patient, 40-64 years

Medicare CPT 99396 pays $128.93 in a non-facility setting and $81.16 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $118.32 in Arkansas to $162.85 in Alaska, a 38% spread.

Web page: https://www.med-reveal.com/rates/99396-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Clinic/Center, Evaluation, Family Medicine, Internal Medicine, Obstetrics & Gynecology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $128.93 |
| National facility | $81.16 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $162.85 | $111.99 |
| District of Columbia | $143.75 | $87.48 |
| California | $140.63 | $84.11 |
| New York | $140.48 | $87.20 |
| New Jersey | $140.27 | $86.49 |
| Washington | $138.69 | $84.24 |
| Massachusetts | $137.70 | $84.04 |
| Connecticut | $135.77 | $84.33 |
| Hawaii | $135.66 | $81.35 |
| Florida | $132.93 | $85.00 |
| Colorado | $132.74 | $81.92 |
| Maryland | $132.68 | $82.88 |
| Rhode Island | $131.73 | $82.39 |
| Oregon | $131.62 | $81.30 |
| New Hampshire | $130.95 | $81.22 |
| Illinois | $130.73 | $84.58 |
| Puerto Rico | $129.54 | $81.25 |
| Virgin Islands | $129.54 | $81.25 |
| Montana | $128.92 | $81.16 |
| Pennsylvania | $128.52 | $81.73 |
| Nevada | $128.32 | $80.51 |
| Delaware | $128.10 | $80.91 |
| Texas | $128.04 | $81.02 |
| Minnesota | $127.89 | $78.74 |
| Wyoming | $127.89 | $80.12 |
| Georgia | $126.99 | $81.41 |
| Michigan | $126.82 | $81.96 |
| Virginia | $126.70 | $79.75 |
| North Dakota | $126.55 | $78.78 |
| Arizona | $126.45 | $80.16 |
| Vermont | $126.33 | $79.05 |
| South Dakota | $126.27 | $78.50 |
| Utah | $124.83 | $79.93 |
| Maine | $124.70 | $79.06 |
| New Mexico | $124.63 | $80.83 |
| Missouri | $123.81 | $79.97 |
| Louisiana | $123.77 | $80.16 |
| South Carolina | $123.66 | $79.52 |
| Ohio | $123.61 | $80.00 |
| Wisconsin | $123.57 | $77.82 |
| North Carolina | $123.36 | $78.80 |
| West Virginia | $122.60 | $81.10 |
| Indiana | $122.38 | $78.10 |
| Idaho | $121.90 | $77.96 |
| Kentucky | $121.76 | $79.30 |
| Nebraska | $121.70 | $77.62 |
| Tennessee | $121.48 | $78.06 |
| Oklahoma | $121.46 | $78.81 |
| Iowa | $121.29 | $77.58 |
| Kansas | $121.04 | $77.86 |
| Alabama | $119.51 | $77.71 |
| Mississippi | $119.34 | $78.21 |
| Arkansas | $118.32 | $77.29 |

## Related codes

- 99381: Initial preventive medicine visit, new patient, infant (under 1 year) — https://www.med-reveal.com/rates/99381-cpt-fee-schedule
- 99382: Initial preventive medicine visit, new patient, early childhood (1-4 years) — https://www.med-reveal.com/rates/99382-cpt-fee-schedule
- 99383: Initial preventive medicine visit, new patient, late childhood (5-11 years) — https://www.med-reveal.com/rates/99383-cpt-fee-schedule
- 99384: Initial preventive medicine visit, new patient, adolescent (12-17 years) — https://www.med-reveal.com/rates/99384-cpt-fee-schedule
- 99385: Initial preventive medicine visit, new patient, 18-39 years — https://www.med-reveal.com/rates/99385-cpt-fee-schedule
- 99386: Initial preventive medicine visit, new patient, 40-64 years — https://www.med-reveal.com/rates/99386-cpt-fee-schedule
- 99387: Initial preventive medicine visit, new patient, 65 years and older — https://www.med-reveal.com/rates/99387-cpt-fee-schedule
- 99391: Periodic preventive medicine visit, established patient, infant (under 1 year) — https://www.med-reveal.com/rates/99391-cpt-fee-schedule

Commercial negotiated rates for 99396 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