CPT 99426

Principal Care Mgmt Svc 1st 30 Staff Cal Mo

CPT 99426 pays $67.80 in a non-facility setting and $44.09 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $62.15 in Arkansas to $85.54 in Alaska, a 38% spread.

National non-facility rate

$67.80

Office and other outpatient settings

Facility rate
$44.09

Hospital and ASC settings

Highest state
$85.54

Alaska

Lowest state
$62.15

Arkansas · 38% 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 $67.80
CPT 99426 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $67.80, national facility $44.09.
StateRate compared visuallyNon-facilityFacility
Alaska
$85.54$60.28
District of Columbia
$75.58$47.64
New York
$73.93$47.48
California
$73.81$45.75
New Jersey
$73.76$47.05
Washington
$72.85$45.82
Massachusetts
$72.35$45.71
Connecticut
$71.43$45.89
Hawaii
$71.21$44.25
Florida
$70.12$46.33
Maryland
$69.78$45.06
Colorado
$69.74$44.51
Rhode Island
$69.24$44.75
Oregon
$69.14$44.16
Illinois
$68.97$46.05
New Hampshire
$68.83$44.14
Puerto Rico
$68.12$44.15
Virgin Islands
$68.12$44.15
Montana
$67.80$44.08
Pennsylvania
$67.61$44.38
Nevada
$67.45$43.71
Delaware
$67.35$43.92
Texas
$67.32$43.98
Wyoming
$67.20$43.48
Minnesota
$67.09$42.69
Georgia
$66.84$44.21
Michigan
$66.80$44.53
Virginia
$66.57$43.26
Arizona
$66.47$43.49
North Dakota
$66.42$42.70
Vermont
$66.33$42.85
South Dakota
$66.25$42.54
Utah
$65.64$43.35
New Mexico
$65.61$43.87
Maine
$65.50$42.84
Missouri
$65.13$43.37
Louisiana
$65.12$43.47
Ohio
$65.03$43.38
South Carolina
$65.02$43.10
Wisconsin
$64.84$42.12
North Carolina
$64.81$42.69
West Virginia
$64.61$44.00
Indiana
$64.26$42.28
Kentucky
$64.05$42.96
Idaho
$64.01$42.19
Nebraska
$63.88$41.99
Oklahoma
$63.85$42.67
Tennessee
$63.80$42.25
Iowa
$63.67$41.97
Kansas
$63.57$42.13
Alabama
$62.78$42.03
Mississippi
$62.74$42.32
Arkansas
$62.15$41.78

Billed by 1 specialties

Commercial rates for 99426

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

See negotiated rates