CPT 99402

Prev Med Cnsl&/Rsk Fctr Rdctj Indv Approx 30 Min

CPT 99402 pays $64.80 in a non-facility setting and $42.09 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $59.59 in Arkansas to $82.22 in Alaska, a 38% spread.

National non-facility rate

$64.80

Office and other outpatient settings

Facility rate
$42.09

Hospital and ASC settings

Highest state
$82.22

Alaska

Lowest state
$59.59

Arkansas · 38% 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 $64.80
CPT 99402 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $64.80, national facility $42.09.
StateRate compared visuallyNon-facilityFacility
Alaska
$82.22$58.03
District of Columbia
$72.14$45.39
California
$70.56$43.69
New York
$70.54$45.21
New Jersey
$70.44$44.86
Washington
$69.61$43.72
Massachusetts
$69.13$43.61
Connecticut
$68.19$43.73
Hawaii
$68.07$42.25
Florida
$66.80$44.01
Colorado
$66.68$42.51
Maryland
$66.66$42.98
Rhode Island
$66.20$42.73
Oregon
$66.11$42.19
New Hampshire
$65.78$42.14
Illinois
$65.72$43.78
Puerto Rico
$65.10$42.14
Virgin Islands
$65.10$42.14
Montana
$64.79$42.08
Pennsylvania
$64.61$42.37
Nevada
$64.49$41.76
Delaware
$64.40$41.96
Texas
$64.37$42.01
Wyoming
$64.28$41.56
Minnesota
$64.26$40.89
Georgia
$63.86$42.19
Michigan
$63.78$42.45
Virginia
$63.70$41.37
North Dakota
$63.61$40.89
Arizona
$63.58$41.57
Vermont
$63.51$41.02
South Dakota
$63.47$40.75
Utah
$62.79$41.44
Maine
$62.71$41.01
New Mexico
$62.71$41.88
Missouri
$62.29$41.45
Louisiana
$62.28$41.54
South Carolina
$62.21$41.23
Ohio
$62.20$41.46
Wisconsin
$62.15$40.39
North Carolina
$62.06$40.87
West Virginia
$61.72$41.99
Indiana
$61.57$40.52
Idaho
$61.34$40.44
Kentucky
$61.29$41.10
Nebraska
$61.24$40.27
Oklahoma
$61.13$40.85
Tennessee
$61.13$40.49
Iowa
$61.03$40.25
Kansas
$60.92$40.39
Alabama
$60.17$40.30
Mississippi
$60.10$40.54
Arkansas
$59.59$40.08

Billed by 1 specialties

Commercial rates for 99402

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

See negotiated rates