CPT 99474

Self-Meas Bp 2 Readg 1 Min Apart Bid 30 Day Pd

CPT 99474 pays $18.37 in a non-facility setting and $8.02 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $16.51 in Arkansas to $22.01 in Alaska, a 33% spread.

National non-facility rate

$18.37

Office and other outpatient settings

Facility rate
$8.02

Hospital and ASC settings

Highest state
$22.01

Alaska

Lowest state
$16.51

Arkansas · 33% 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 $18.37
CPT 99474 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $18.37, national facility $8.02.
StateRate compared visuallyNon-facilityFacility
Alaska
$22.01$10.98
District of Columbia
$20.87$8.68
California
$20.64$8.38
New Jersey
$20.22$8.56
New York
$20.17$8.61
Washington
$20.17$8.37
Massachusetts
$19.97$8.34
Hawaii
$19.88$8.10
Connecticut
$19.49$8.34
Colorado
$19.14$8.12
Maryland
$18.99$8.19
Oregon
$18.97$8.06
Rhode Island
$18.85$8.15
New Hampshire
$18.82$8.04
Florida
$18.73$8.34
Puerto Rico
$18.50$8.03
Virgin Islands
$18.50$8.03
Minnesota
$18.48$7.83
Montana
$18.37$8.02
Nevada
$18.33$7.96
Illinois
$18.29$8.29
Wyoming
$18.28$7.93
Delaware
$18.22$7.99
Pennsylvania
$18.20$8.06
Texas
$18.19$8.00
North Dakota
$18.17$7.82
South Dakota
$18.15$7.79
Vermont
$18.09$7.83
Virginia
$18.07$7.89
Arizona
$17.95$7.92
Georgia
$17.89$8.01
Michigan
$17.77$8.05
Maine
$17.71$7.82
Wisconsin
$17.63$7.71
Utah
$17.61$7.88
New Mexico
$17.44$7.94
North Carolina
$17.44$7.78
South Carolina
$17.41$7.84
Missouri
$17.38$7.87
Louisiana
$17.34$7.89
Ohio
$17.33$7.87
Indiana
$17.32$7.72
Nebraska
$17.24$7.68
Idaho
$17.23$7.71
Iowa
$17.15$7.67
Tennessee
$17.12$7.71
Kansas
$17.05$7.69
Kentucky
$17.01$7.80
Oklahoma
$17.01$7.76
West Virginia
$16.94$7.94
Alabama
$16.72$7.66
Mississippi
$16.61$7.70
Arkansas
$16.51$7.62

Billed by 1 specialties

Commercial rates for 99474

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

See negotiated rates