CPT 99424

Principal Care Mgmt Svc 1st 30 Phys/Qhp Cal Mo

CPT 99424 pays $87.51 in a non-facility setting and $64.80 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $80.74 in Arkansas to $112.38 in Alaska, a 39% spread.

National non-facility rate

$87.51

Office and other outpatient settings

Facility rate
$64.80

Hospital and ASC settings

Highest state
$112.38

Alaska

Lowest state
$80.74

Arkansas · 39% 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 $87.51
CPT 99424 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $87.51, national facility $64.80.
StateRate compared visuallyNon-facilityFacility
Alaska
$112.38$88.19
District of Columbia
$96.84$70.09
New York
$95.22$69.88
New Jersey
$94.77$69.19
California
$94.05$67.18
Washington
$93.22$67.33
Massachusetts
$92.69$67.17
Connecticut
$91.98$67.52
Florida
$91.11$68.32
Hawaii
$90.81$64.99
Maryland
$89.93$66.25
Illinois
$89.83$67.89
Colorado
$89.55$65.39
Rhode Island
$89.20$65.74
Oregon
$88.78$64.85
New Hampshire
$88.50$64.86
Puerto Rico
$87.84$64.88
Virgin Islands
$87.84$64.88
Montana
$87.50$64.79
Pennsylvania
$87.47$65.23
Texas
$86.97$64.61
Delaware
$86.96$64.52
Nevada
$86.93$64.20
Michigan
$86.85$65.52
Georgia
$86.68$65.01
Wyoming
$86.56$63.84
Minnesota
$85.95$62.58
Arizona
$85.88$63.88
Virginia
$85.83$63.50
Vermont
$85.34$62.86
North Dakota
$85.33$62.62
New Mexico
$85.31$64.48
South Dakota
$85.07$62.36
Utah
$85.01$63.66
Louisiana
$84.60$63.87
Maine
$84.56$62.86
Missouri
$84.54$63.70
Ohio
$84.46$63.72
West Virginia
$84.46$64.72
South Carolina
$84.27$63.28
North Carolina
$83.81$62.62
Wisconsin
$83.48$61.72
Kentucky
$83.27$63.08
Indiana
$83.04$61.98
Oklahoma
$82.90$62.62
Idaho
$82.74$61.85
Tennessee
$82.59$61.94
Nebraska
$82.50$61.54
Iowa
$82.29$61.50
Kansas
$82.29$61.76
Mississippi
$81.63$62.07
Alabama
$81.49$61.62
Arkansas
$80.74$61.23

Billed by 1 specialties

Commercial rates for 99424

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

See negotiated rates