# CPT 99468: Neonatal critical care, initial inpatient care, per day, for a critically ill neonate (28 days of age or younger)

Medicare CPT 99468 pays $778.57 in a non-facility setting and $778.57 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $742.64 in Arkansas to $1,077.82 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99468-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $778.57 |
| National facility | $778.57 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $1,077.82 | $1,077.82 |
| District of Columbia | $838.23 | $838.23 |
| New York | $835.82 | $835.82 |
| New Jersey | $829.09 | $829.09 |
| Florida | $815.04 | $815.04 |
| Illinois | $811.24 | $811.24 |
| Connecticut | $808.44 | $808.44 |
| Washington | $807.32 | $807.32 |
| California | $805.95 | $805.95 |
| Massachusetts | $805.50 | $805.50 |
| Maryland | $794.81 | $794.81 |
| Rhode Island | $790.27 | $790.27 |
| Michigan | $786.54 | $786.54 |
| Colorado | $785.57 | $785.57 |
| Pennsylvania | $784.21 | $784.21 |
| Georgia | $781.28 | $781.28 |
| Oregon | $779.61 | $779.61 |
| Hawaii | $779.52 | $779.52 |
| Puerto Rico | $779.37 | $779.37 |
| Virgin Islands | $779.37 | $779.37 |
| New Hampshire | $778.90 | $778.90 |
| West Virginia | $778.75 | $778.75 |
| Montana | $778.50 | $778.50 |
| Texas | $777.34 | $777.34 |
| Delaware | $776.33 | $776.33 |
| New Mexico | $775.94 | $775.94 |
| Nevada | $772.34 | $772.34 |
| Louisiana | $769.59 | $769.59 |
| Arizona | $769.25 | $769.25 |
| Wyoming | $768.67 | $768.67 |
| Ohio | $768.10 | $768.10 |
| Missouri | $767.77 | $767.77 |
| Utah | $767.26 | $767.26 |
| Virginia | $765.27 | $765.27 |
| South Carolina | $763.45 | $763.45 |
| Kentucky | $761.58 | $761.58 |
| Maine | $758.84 | $758.84 |
| Vermont | $758.53 | $758.53 |
| Oklahoma | $756.82 | $756.82 |
| North Carolina | $756.53 | $756.53 |
| North Dakota | $755.96 | $755.96 |
| Minnesota | $755.36 | $755.36 |
| South Dakota | $753.29 | $753.29 |
| Mississippi | $751.41 | $751.41 |
| Indiana | $749.96 | $749.96 |
| Tennessee | $749.67 | $749.67 |
| Idaho | $748.59 | $748.59 |
| Kansas | $747.79 | $747.79 |
| Wisconsin | $747.02 | $747.02 |
| Alabama | $746.56 | $746.56 |
| Nebraska | $745.35 | $745.35 |
| Iowa | $745.08 | $745.08 |
| Arkansas | $742.64 | $742.64 |

## Related codes

- 99291: Critical care, evaluation and management of the critically ill or injured patient, first 30-74 minutes — https://www.med-reveal.com/rates/99291-cpt-fee-schedule
- 99292: Critical care, each additional 30 minutes (add-on) — https://www.med-reveal.com/rates/99292-cpt-fee-schedule
- 99469: Neonatal critical care, subsequent inpatient care, per day, for a critically ill neonate — https://www.med-reveal.com/rates/99469-cpt-fee-schedule
- 99471: Pediatric critical care, initial inpatient care, per day, for a critically ill infant (29 days through 24 months) — https://www.med-reveal.com/rates/99471-cpt-fee-schedule
- 99472: Pediatric critical care, subsequent inpatient care, per day, for a critically ill infant — https://www.med-reveal.com/rates/99472-cpt-fee-schedule
- 99475: Pediatric critical care, initial inpatient care, per day, for a critically ill patient (2 through 5 years) — https://www.med-reveal.com/rates/99475-cpt-fee-schedule
- 99476: Pediatric critical care, subsequent inpatient care, per day, for a critically ill patient — https://www.med-reveal.com/rates/99476-cpt-fee-schedule
- 99477: Initial hospital care, per day, for a neonate requiring intensive observation, not critically ill — https://www.med-reveal.com/rates/99477-cpt-fee-schedule

Commercial negotiated rates for 99468 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