# CPT 99463: 1st Hosp/birthing Center Nb Admit & Dschg Sm Dat

Medicare CPT 99463 pays $94.86 in a non-facility setting and $94.86 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $90.02 in Arkansas to $129.74 in Alaska, a 44% spread.

Web page: https://www.med-reveal.com/rates/99463-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, Pediatrics

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $94.86 |
| National facility | $94.86 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $129.74 | $129.74 |
| District of Columbia | $102.64 | $102.64 |
| New York | $102.03 | $102.03 |
| New Jersey | $101.32 | $101.32 |
| Florida | $99.03 | $99.03 |
| California | $98.97 | $98.97 |
| Washington | $98.90 | $98.90 |
| Connecticut | $98.68 | $98.68 |
| Massachusetts | $98.60 | $98.60 |
| Illinois | $98.41 | $98.41 |
| Maryland | $96.95 | $96.95 |
| Rhode Island | $96.38 | $96.38 |
| Colorado | $96.00 | $96.00 |
| Hawaii | $95.68 | $95.68 |
| Michigan | $95.45 | $95.45 |
| Pennsylvania | $95.40 | $95.40 |
| Oregon | $95.27 | $95.27 |
| New Hampshire | $95.11 | $95.11 |
| Puerto Rico | $95.01 | $95.01 |
| Virgin Islands | $95.01 | $95.01 |
| Georgia | $94.93 | $94.93 |
| Montana | $94.85 | $94.85 |
| Texas | $94.64 | $94.64 |
| Delaware | $94.54 | $94.54 |
| West Virginia | $94.19 | $94.19 |
| Nevada | $94.15 | $94.15 |
| New Mexico | $94.12 | $94.12 |
| Wyoming | $93.73 | $93.73 |
| Arizona | $93.63 | $93.63 |
| Louisiana | $93.38 | $93.38 |
| Utah | $93.25 | $93.25 |
| Virginia | $93.25 | $93.25 |
| Ohio | $93.21 | $93.21 |
| Missouri | $93.20 | $93.20 |
| South Carolina | $92.73 | $92.73 |
| Vermont | $92.52 | $92.52 |
| Maine | $92.38 | $92.38 |
| Minnesota | $92.36 | $92.36 |
| Kentucky | $92.34 | $92.34 |
| North Dakota | $92.28 | $92.28 |
| North Carolina | $91.99 | $91.99 |
| South Dakota | $91.98 | $91.98 |
| Oklahoma | $91.82 | $91.82 |
| Indiana | $91.21 | $91.21 |
| Tennessee | $91.09 | $91.09 |
| Wisconsin | $91.04 | $91.04 |
| Mississippi | $91.03 | $91.03 |
| Idaho | $91.02 | $91.02 |
| Kansas | $90.85 | $90.85 |
| Nebraska | $90.67 | $90.67 |
| Iowa | $90.59 | $90.59 |
| Alabama | $90.55 | $90.55 |
| Arkansas | $90.02 | $90.02 |

## Related codes

- 99201: New Patient Office Visit: Coverage and Documentation Requirements — https://www.med-reveal.com/rates/99201-cpt-fee-schedule
- 99241: Office consultation for a new or established patient that requires these three key components: a problem-focused history; a problem-focused examination; and straightforward medical decision-making — https://www.med-reveal.com/rates/99241-cpt-fee-schedule
- 99251: Inpatient consultation for a new or established patient which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. — https://www.med-reveal.com/rates/99251-cpt-fee-schedule
- 99288: Phys/qhp Direction Emergency Medical Systems — https://www.med-reveal.com/rates/99288-cpt-fee-schedule
- 99354: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99354-cpt-fee-schedule
- 99355: Prolonged Service With Direct Patient Contact — https://www.med-reveal.com/rates/99355-cpt-fee-schedule
- 99358: Prolng E/m Svc Before&/after Dir Pt Care 1st Hr — https://www.med-reveal.com/rates/99358-cpt-fee-schedule
- 99359: Prolng E/m Before&/after Dir Care Ea 30 Minutes — https://www.med-reveal.com/rates/99359-cpt-fee-schedule

Commercial negotiated rates for 99463 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