# CPT 99418: Prolonged Inpatient/observation Em Svc Ea 15 Min

Medicare 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.

Web page: https://www.med-reveal.com/rates/99418-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $34.74 |
| National facility | $34.74 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $47.91 | $47.91 |
| District of Columbia | $37.46 | $37.46 |
| New York | $37.32 | $37.32 |
| 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 | $34.82 | $34.82 |
| 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 |
| Louisiana | $34.30 | $34.30 |
| Wyoming | $34.30 | $34.30 |
| Ohio | $34.23 | $34.23 |
| Missouri | $34.21 | $34.21 |
| 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 |

## Related codes

- 99201: New Patient Office Visit: Coverage and Documentation Requirements — https://www.med-reveal.com/rates/99201-cpt-fee-schedule
- 99241: Office consultation for a new or established patient that requires these three key components: a problem-focused history; a problem-focused examination; and straightforward medical decision-making — https://www.med-reveal.com/rates/99241-cpt-fee-schedule
- 99251: Inpatient consultation for a new or established patient which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. — https://www.med-reveal.com/rates/99251-cpt-fee-schedule
- 99288: Phys/qhp Direction Emergency Medical Systems — https://www.med-reveal.com/rates/99288-cpt-fee-schedule
- 99354: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99354-cpt-fee-schedule
- 99355: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99355-cpt-fee-schedule
- 99358: Prolng E/m Svc Before&/after Dir Pt Care 1st Hr — https://www.med-reveal.com/rates/99358-cpt-fee-schedule
- 99359: Prolng E/m Before&/after Dir Care Ea 30 Minutes — https://www.med-reveal.com/rates/99359-cpt-fee-schedule

Commercial negotiated rates for 99418 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules