CPT 99452

Ntrprof Phone/Ntrnet/Ehr Referral Svc 30 Min

CPT 99452 pays $37.07 in a non-facility setting and $31.06 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $34.57 in Arkansas to $48.80 in Alaska, a 41% spread.

National non-facility rate

$37.07

Office and other outpatient settings

Facility rate
$31.06

Hospital and ASC settings

Highest state
$48.80

Alaska

Lowest state
$34.57

Arkansas · 41% 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 $37.07
CPT 99452 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $37.07, national facility $31.06.
StateRate compared visuallyNon-facilityFacility
Alaska
$48.80$42.39
District of Columbia
$40.67$33.58
New York
$40.17$33.47
New Jersey
$39.93$33.16
California
$39.35$32.24
Washington
$39.14$32.29
Massachusetts
$38.96$32.21
Connecticut
$38.82$32.34
Florida
$38.70$32.66
Illinois
$38.27$32.46
Hawaii
$38.02$31.18
Maryland
$38.02$31.75
Colorado
$37.76$31.36
Rhode Island
$37.74$31.53
Oregon
$37.44$31.11
New Hampshire
$37.36$31.10
Puerto Rico
$37.18$31.10
Virgin Islands
$37.18$31.10
Pennsylvania
$37.15$31.27
Montana
$37.07$31.06
Michigan
$37.02$31.38
Texas
$36.90$30.98
Georgia
$36.89$31.15
Delaware
$36.88$30.94
Nevada
$36.81$30.79
Wyoming
$36.64$30.63
Arizona
$36.46$30.64
New Mexico
$36.41$30.90
Virginia
$36.38$30.47
Minnesota
$36.25$30.06
West Virginia
$36.22$31.00
Utah
$36.18$30.53
Vermont
$36.13$30.18
Louisiana
$36.11$30.62
North Dakota
$36.08$30.07
Missouri
$36.06$30.54
Ohio
$36.04$30.55
South Dakota
$35.97$29.95
Maine
$35.92$30.17
South Carolina
$35.91$30.36
North Carolina
$35.67$30.06
Kentucky
$35.60$30.25
Oklahoma
$35.42$30.05
Wisconsin
$35.41$29.65
Indiana
$35.34$29.77
Idaho
$35.23$29.70
Tennessee
$35.21$29.74
Nebraska
$35.11$29.56
Kansas
$35.09$29.66
Iowa
$35.05$29.54
Mississippi
$34.97$29.79
Alabama
$34.85$29.59
Arkansas
$34.57$29.41

Billed by 1 specialties

Commercial rates for 99452

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

See negotiated rates