CPT 99418

Prolonged Inpatient/Observation Em Svc Ea 15 Min

CPT 99418 pays $34.74 in a non-facility setting and $34.74 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $33.08 in Arkansas to $47.91 in Alaska, a 45% spread.

National non-facility rate

$34.74

Office and other outpatient settings

Facility rate
$34.74

Hospital and ASC settings

Highest state
$47.91

Alaska

Lowest state
$33.08

Arkansas · 45% 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 $34.74
CPT 99418 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $34.74, national facility $34.74.
StateRate compared visuallyNon-facilityFacility
Alaska
$47.91$47.91
District of Columbia
$37.46$37.46
New York
$37.31$37.31
New Jersey
$37.03$37.03
Florida
$36.34$36.34
Illinois
$36.15$36.15
Connecticut
$36.09$36.09
Washington
$36.08$36.08
California
$36.04$36.04
Massachusetts
$35.99$35.99
Maryland
$35.47$35.47
Rhode Island
$35.27$35.27
Colorado
$35.08$35.08
Michigan
$35.05$35.05
Pennsylvania
$34.97$34.97
Hawaii
$34.86$34.86
Georgia
$34.83$34.83
Oregon
$34.81$34.81
Puerto Rico
$34.78$34.78
Virgin Islands
$34.78$34.78
New Hampshire
$34.77$34.77
Montana
$34.73$34.73
Texas
$34.67$34.67
West Virginia
$34.67$34.67
Delaware
$34.63$34.63
New Mexico
$34.57$34.57
Nevada
$34.46$34.46
Arizona
$34.31$34.31
Wyoming
$34.30$34.30
Louisiana
$34.29$34.29
Ohio
$34.23$34.23
Missouri
$34.22$34.22
Utah
$34.21$34.21
Virginia
$34.14$34.14
South Carolina
$34.03$34.03
Kentucky
$33.93$33.93
Maine
$33.85$33.85
Vermont
$33.85$33.85
Minnesota
$33.74$33.74
North Dakota
$33.74$33.74
North Carolina
$33.73$33.73
Oklahoma
$33.72$33.72
South Dakota
$33.63$33.63
Mississippi
$33.47$33.47
Indiana
$33.44$33.44
Tennessee
$33.42$33.42
Idaho
$33.38$33.38
Kansas
$33.33$33.33
Wisconsin
$33.33$33.33
Alabama
$33.26$33.26
Nebraska
$33.24$33.24
Iowa
$33.22$33.22
Arkansas
$33.08$33.08

Billed by 1 specialties

Commercial rates for 99418

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

See negotiated rates