# CPT 99423: Online digital E/M service, established patient, 21 minutes or more cumulative over 7 days

Medicare CPT 99423 pays $48.77 in a non-facility setting and $35.07 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $45.08 in Arkansas to $62.70 in Alaska, a 39% spread.

Web page: https://www.med-reveal.com/rates/99423-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, Psychiatry & Neurology, Pulmonary Disease, Rheumatology, Sleep Medicine, Sports Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $48.77 |
| National facility | $35.07 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $62.70 | $48.12 |
| District of Columbia | $54.02 | $37.89 |
| New York | $52.99 | $37.71 |
| New Jersey | $52.85 | $37.43 |
| California | $52.69 | $36.49 |
| Washington | $52.11 | $36.49 |
| Massachusetts | $51.78 | $36.39 |
| Connecticut | $51.22 | $36.47 |
| Hawaii | $50.85 | $35.28 |
| Florida | $50.41 | $36.68 |
| Maryland | $50.11 | $35.83 |
| Colorado | $50.02 | $35.45 |
| Rhode Island | $49.77 | $35.62 |
| Illinois | $49.69 | $36.46 |
| Oregon | $49.61 | $35.18 |
| New Hampshire | $49.39 | $35.14 |
| Puerto Rico | $48.96 | $35.12 |
| Virgin Islands | $48.96 | $35.12 |
| Montana | $48.76 | $35.07 |
| Pennsylvania | $48.70 | $35.29 |
| Nevada | $48.51 | $34.80 |
| Delaware | $48.49 | $34.96 |
| Texas | $48.48 | $35.00 |
| Wyoming | $48.33 | $34.64 |
| Michigan | $48.21 | $35.35 |
| Georgia | $48.20 | $35.13 |
| Minnesota | $48.18 | $34.09 |
| Virginia | $47.93 | $34.47 |
| Arizona | $47.89 | $34.62 |
| North Dakota | $47.77 | $34.08 |
| Vermont | $47.74 | $34.18 |
| South Dakota | $47.66 | $33.96 |
| New Mexico | $47.41 | $34.85 |
| Utah | $47.37 | $34.50 |
| Maine | $47.24 | $34.15 |
| Louisiana | $47.07 | $34.57 |
| Missouri | $47.06 | $34.50 |
| Ohio | $47.01 | $34.50 |
| South Carolina | $46.97 | $34.31 |
| West Virginia | $46.82 | $34.92 |
| North Carolina | $46.80 | $34.02 |
| Wisconsin | $46.75 | $33.63 |
| Indiana | $46.42 | $33.72 |
| Kentucky | $46.36 | $34.19 |
| Idaho | $46.26 | $33.66 |
| Oklahoma | $46.21 | $33.98 |
| Nebraska | $46.16 | $33.52 |
| Tennessee | $46.14 | $33.69 |
| Iowa | $46.03 | $33.50 |
| Kansas | $45.98 | $33.60 |
| Mississippi | $45.50 | $33.71 |
| Alabama | $45.49 | $33.51 |
| Arkansas | $45.08 | $33.32 |

## 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 99423 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