# CPT 99421: Online digital E/M service, established patient, 5-10 minutes cumulative over 7 days

Medicare CPT 99421 pays $15.70 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 $14.43 in Arkansas to $20.01 in Alaska, a 39% spread.

Web page: https://www.med-reveal.com/rates/99421-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Child & Adolescent Psychiatry, Clinic/Center, Clinical Genetics (M.D.), Endocrinology, Evaluation, Family Medicine, Hematology & Oncology, Infectious Disease, Internal Medicine, Neurology, Ophthalmology, Optometrist, Pain Medicine, Pediatrics, Psychiatry & Neurology, Pulmonary Disease, Rheumatology, Sleep Medicine, Sports Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $15.70 |
| National facility | $11.02 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $20.01 | $15.03 |
| District of Columbia | $17.41 | $11.91 |
| New York | $17.11 | $11.89 |
| New Jersey | $17.02 | $11.76 |
| California | $16.92 | $11.38 |
| Washington | $16.76 | $11.43 |
| Massachusetts | $16.66 | $11.41 |
| Connecticut | $16.52 | $11.48 |
| Florida | $16.35 | $11.66 |
| Hawaii | $16.33 | $11.02 |
| Maryland | $16.15 | $11.27 |
| Illinois | $16.11 | $11.59 |
| Colorado | $16.08 | $11.10 |
| Rhode Island | $16.01 | $11.17 |
| Oregon | $15.93 | $11.02 |
| New Hampshire | $15.89 | $11.02 |
| Puerto Rico | $15.76 | $11.03 |
| Virgin Islands | $15.76 | $11.03 |
| Montana | $15.70 | $11.02 |
| Pennsylvania | $15.68 | $11.10 |
| Delaware | $15.59 | $10.97 |
| Nevada | $15.59 | $10.91 |
| Texas | $15.59 | $10.99 |
| Michigan | $15.56 | $11.17 |
| Georgia | $15.54 | $11.07 |
| Wyoming | $15.52 | $10.85 |
| Minnesota | $15.42 | $10.61 |
| Arizona | $15.40 | $10.86 |
| Virginia | $15.39 | $10.79 |
| North Dakota | $15.30 | $10.63 |
| Vermont | $15.30 | $10.67 |
| New Mexico | $15.28 | $10.99 |
| South Dakota | $15.25 | $10.58 |
| Utah | $15.23 | $10.83 |
| Louisiana | $15.15 | $10.88 |
| Maine | $15.15 | $10.68 |
| Missouri | $15.14 | $10.85 |
| Ohio | $15.12 | $10.85 |
| West Virginia | $15.11 | $11.05 |
| South Carolina | $15.09 | $10.77 |
| North Carolina | $15.01 | $10.65 |
| Wisconsin | $14.96 | $10.48 |
| Kentucky | $14.90 | $10.74 |
| Indiana | $14.87 | $10.53 |
| Oklahoma | $14.83 | $10.66 |
| Idaho | $14.81 | $10.51 |
| Tennessee | $14.78 | $10.53 |
| Nebraska | $14.77 | $10.45 |
| Iowa | $14.73 | $10.45 |
| Kansas | $14.73 | $10.50 |
| Mississippi | $14.60 | $10.57 |
| Alabama | $14.57 | $10.48 |
| Arkansas | $14.43 | $10.42 |

## Related codes

- 98000: Synchronous audio-video telemedicine E/M service, new patient, straightforward medical decision making — https://www.med-reveal.com/rates/98000-cpt-fee-schedule
- 98001: Synchronous audio-video telemedicine E/M service, new patient, low medical decision making — https://www.med-reveal.com/rates/98001-cpt-fee-schedule
- 98002: Synchronous audio-video telemedicine E/M service, new patient, moderate medical decision making — https://www.med-reveal.com/rates/98002-cpt-fee-schedule
- 98003: Synchronous audio-video telemedicine E/M service, new patient, high medical decision making — https://www.med-reveal.com/rates/98003-cpt-fee-schedule
- 98004: Synchronous audio-video telemedicine E/M service, established patient, straightforward medical decision making — https://www.med-reveal.com/rates/98004-cpt-fee-schedule
- 98005: Synchronous audio-video telemedicine E/M service, established patient, low medical decision making — https://www.med-reveal.com/rates/98005-cpt-fee-schedule
- 98006: Synchronous audio-video telemedicine E/M service, established patient, moderate medical decision making — https://www.med-reveal.com/rates/98006-cpt-fee-schedule
- 98007: Synchronous audio-video telemedicine E/M service, established patient, high medical decision making — https://www.med-reveal.com/rates/98007-cpt-fee-schedule

Commercial negotiated rates for 99421 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