CPT 99412

Prev Med Counsel & Risk Factor Redj Grp Spx 60 M

CPT 99412 pays $25.38 in a non-facility setting and $11.02 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $22.75 in Arkansas to $30.32 in Alaska, a 33% spread.

National non-facility rate

$25.38

Office and other outpatient settings

Facility rate
$11.02

Hospital and ASC settings

Highest state
$30.32

Alaska

Lowest state
$22.75

Arkansas · 33% 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 $25.38
CPT 99412 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $25.38, national facility $11.02.
StateRate compared visuallyNon-facilityFacility
Alaska
$30.32$15.03
District of Columbia
$28.82$11.91
California
$28.38$11.38
New Jersey
$27.93$11.76
New York
$27.91$11.89
Washington
$27.80$11.42
Massachusetts
$27.54$11.40
Hawaii
$27.35$11.02
Connecticut
$26.95$11.48
Colorado
$26.39$11.10
Maryland
$26.24$11.27
Oregon
$26.14$11.01
Florida
$26.07$11.66
Rhode Island
$26.01$11.17
New Hampshire
$25.97$11.02
Puerto Rico
$25.55$11.03
Virgin Islands
$25.55$11.03
Illinois
$25.47$11.59
Minnesota
$25.39$10.61
Montana
$25.38$11.02
Nevada
$25.29$10.91
Wyoming
$25.21$10.85
Pennsylvania
$25.17$11.10
Delaware
$25.16$10.97
Texas
$25.13$10.99
North Dakota
$24.99$10.63
South Dakota
$24.94$10.58
Virginia
$24.91$10.79
Vermont
$24.89$10.67
Arizona
$24.78$10.86
Georgia
$24.78$11.07
Michigan
$24.66$11.17
Maine
$24.41$10.68
Utah
$24.33$10.83
Wisconsin
$24.24$10.48
New Mexico
$24.16$10.99
North Carolina
$24.05$10.65
South Carolina
$24.04$10.77
Missouri
$24.03$10.85
Louisiana
$23.99$10.88
Ohio
$23.97$10.85
Indiana
$23.85$10.53
Idaho
$23.72$10.51
Nebraska
$23.71$10.45
Iowa
$23.59$10.45
Tennessee
$23.59$10.53
West Virginia
$23.53$11.05
Kentucky
$23.51$10.74
Kansas
$23.48$10.50
Oklahoma
$23.48$10.66
Alabama
$23.05$10.48
Mississippi
$22.94$10.57
Arkansas
$22.75$10.42

Billed by 1 specialties

Commercial rates for 99412

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

See negotiated rates