CPT 99411

Prev Med Counsel & Risk Factor Redj Grp Spx 30 M

CPT 99411 pays $20.37 in a non-facility setting and $6.35 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $18.09 in Arkansas to $23.71 in Alaska, a 31% spread.

National non-facility rate

$20.37

Office and other outpatient settings

Facility rate
$6.35

Hospital and ASC settings

Highest state
$23.71

Alaska

Lowest state
$18.09

Arkansas · 31% 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 $20.37
CPT 99411 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $20.37, national facility $6.35.
StateRate compared visuallyNon-facilityFacility
Alaska
$23.71$8.77
District of Columbia
$23.36$6.83
California
$23.16$6.56
Washington
$22.57$6.57
New Jersey
$22.55$6.76
New York
$22.47$6.82
Massachusetts
$22.32$6.56
Hawaii
$22.29$6.34
Connecticut
$21.70$6.59
Colorado
$21.32$6.40
Oregon
$21.13$6.35
Maryland
$21.10$6.48
New Hampshire
$20.95$6.35
Rhode Island
$20.93$6.44
Florida
$20.74$6.67
Minnesota
$20.58$6.14
Puerto Rico
$20.53$6.35
Virgin Islands
$20.53$6.35
Montana
$20.37$6.35
Nevada
$20.33$6.29
Wyoming
$20.29$6.26
Delaware
$20.19$6.33
Illinois
$20.19$6.63
North Dakota
$20.18$6.15
South Dakota
$20.15$6.12
Texas
$20.15$6.33
Pennsylvania
$20.13$6.39
Vermont
$20.06$6.17
Virginia
$20.02$6.23
Arizona
$19.86$6.27
Georgia
$19.76$6.37
Michigan
$19.59$6.42
Maine
$19.58$6.18
Wisconsin
$19.51$6.07
Utah
$19.44$6.25
North Carolina
$19.25$6.16
New Mexico
$19.19$6.33
South Carolina
$19.18$6.22
Missouri
$19.13$6.26
Indiana
$19.11$6.10
Louisiana
$19.08$6.27
Ohio
$19.07$6.26
Nebraska
$19.01$6.06
Idaho
$19.00$6.09
Iowa
$18.90$6.06
Tennessee
$18.85$6.10
Kansas
$18.77$6.08
Oklahoma
$18.69$6.16
Kentucky
$18.68$6.21
West Virginia
$18.55$6.36
Alabama
$18.35$6.08
Mississippi
$18.20$6.12
Arkansas
$18.09$6.04

Billed by 1 specialties

Commercial rates for 99411

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

See negotiated rates