CPT 99401

Prev Med Cnsl&/Rsk Fctr Rdctj Indv Approx 15 Min

CPT 99401 pays $39.75 in a non-facility setting and $20.71 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $36.06 in Arkansas to $48.79 in Alaska, a 35% spread.

National non-facility rate

$39.75

Office and other outpatient settings

Facility rate
$20.71

Hospital and ASC settings

Highest state
$48.79

Alaska

Lowest state
$36.06

Arkansas · 35% 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 $39.75
CPT 99401 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $39.75, national facility $20.71.
StateRate compared visuallyNon-facilityFacility
Alaska
$48.79$28.51
District of Columbia
$44.77$22.34
California
$44.03$21.50
New Jersey
$43.52$22.08
New York
$43.49$22.25
Washington
$43.22$21.52
Massachusetts
$42.85$21.46
Hawaii
$42.44$20.79
Connecticut
$42.03$21.52
Colorado
$41.17$20.92
Maryland
$41.00$21.15
Oregon
$40.81$20.76
Florida
$40.77$21.67
Rhode Island
$40.69$21.03
New Hampshire
$40.55$20.73
Puerto Rico
$39.98$20.73
Virgin Islands
$39.98$20.73
Illinois
$39.95$21.55
Montana
$39.75$20.71
Minnesota
$39.70$20.11
Nevada
$39.60$20.54
Pennsylvania
$39.49$20.85
Wyoming
$39.49$20.45
Delaware
$39.45$20.64
Texas
$39.41$20.67
North Dakota
$39.15$20.11
South Dakota
$39.08$20.04
Virginia
$39.07$20.35
Vermont
$39.02$20.18
Georgia
$38.92$20.76
Arizona
$38.90$20.45
Michigan
$38.77$20.89
Maine
$38.36$20.17
Utah
$38.28$20.39
Wisconsin
$38.10$19.86
New Mexico
$38.06$20.61
South Carolina
$37.87$20.28
Missouri
$37.86$20.39
North Carolina
$37.86$20.10
Louisiana
$37.82$20.44
Ohio
$37.78$20.40
Indiana
$37.57$19.93
Idaho
$37.40$19.89
Nebraska
$37.37$19.80
Tennessee
$37.22$19.91
Iowa
$37.21$19.79
West Virginia
$37.20$20.66
Kentucky
$37.14$20.22
Oklahoma
$37.09$20.09
Kansas
$37.07$19.86
Alabama
$36.47$19.81
Mississippi
$36.33$19.94
Arkansas
$36.06$19.70

Billed by 1 specialties

Commercial rates for 99401

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

See negotiated rates