# CPT 99469: Neonatal critical care, subsequent inpatient care, per day, for a critically ill neonate

Medicare CPT 99469 pays $336.68 in a non-facility setting and $336.68 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $321.32 in Arkansas to $466.41 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99469-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $336.68 |
| National facility | $336.68 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $466.41 | $466.41 |
| District of Columbia | $362.48 | $362.48 |
| New York | $361.31 | $361.31 |
| New Jersey | $358.53 | $358.53 |
| Florida | $352.04 | $352.04 |
| Illinois | $350.41 | $350.41 |
| Connecticut | $349.53 | $349.53 |
| Washington | $349.24 | $349.24 |
| California | $348.76 | $348.76 |
| Massachusetts | $348.42 | $348.42 |
| Maryland | $343.68 | $343.68 |
| Rhode Island | $341.79 | $341.79 |
| Michigan | $339.94 | $339.94 |
| Colorado | $339.81 | $339.81 |
| Pennsylvania | $339.09 | $339.09 |
| Georgia | $337.76 | $337.76 |
| Hawaii | $337.30 | $337.30 |
| Oregon | $337.26 | $337.26 |
| Puerto Rico | $337.03 | $337.03 |
| Virgin Islands | $337.03 | $337.03 |
| New Hampshire | $336.88 | $336.88 |
| Montana | $336.65 | $336.65 |
| West Virginia | $336.55 | $336.55 |
| Texas | $336.17 | $336.17 |
| Delaware | $335.75 | $335.75 |
| New Mexico | $335.44 | $335.44 |
| Nevada | $334.06 | $334.06 |
| Louisiana | $332.76 | $332.76 |
| Arizona | $332.71 | $332.71 |
| Wyoming | $332.51 | $332.51 |
| Ohio | $332.13 | $332.13 |
| Missouri | $332.00 | $332.00 |
| Utah | $331.82 | $331.82 |
| Virginia | $331.05 | $331.05 |
| South Carolina | $330.19 | $330.19 |
| Kentucky | $329.35 | $329.35 |
| Maine | $328.30 | $328.30 |
| Vermont | $328.22 | $328.22 |
| Oklahoma | $327.35 | $327.35 |
| North Carolina | $327.29 | $327.29 |
| North Dakota | $327.16 | $327.16 |
| Minnesota | $326.95 | $326.95 |
| South Dakota | $326.04 | $326.04 |
| Mississippi | $325.02 | $325.02 |
| Indiana | $324.51 | $324.51 |
| Tennessee | $324.36 | $324.36 |
| Idaho | $323.93 | $323.93 |
| Kansas | $323.57 | $323.57 |
| Wisconsin | $323.33 | $323.33 |
| Alabama | $323.00 | $323.00 |
| Nebraska | $322.57 | $322.57 |
| Iowa | $322.44 | $322.44 |
| Arkansas | $321.32 | $321.32 |

## 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
- 99468: Neonatal critical care, initial inpatient care, per day, for a critically ill neonate (28 days of age or younger) — https://www.med-reveal.com/rates/99468-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 99469 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