# CPT 99478: Subsequent Intensive Care Infant < 1500 Grams

Medicare CPT 99478 pays $115.90 in a non-facility setting and $115.90 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $110.56 in Arkansas to $160.47 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99478-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $115.90 |
| National facility | $115.90 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $160.47 | $160.47 |
| District of Columbia | $124.77 | $124.77 |
| New York | $124.42 | $124.42 |
| New Jersey | $123.42 | $123.42 |
| Florida | $121.34 | $121.34 |
| Illinois | $120.78 | $120.78 |
| Connecticut | $120.35 | $120.35 |
| Washington | $120.17 | $120.17 |
| California | $119.96 | $119.96 |
| Massachusetts | $119.90 | $119.90 |
| Maryland | $118.32 | $118.32 |
| Rhode Island | $117.64 | $117.64 |
| Michigan | $117.10 | $117.10 |
| Colorado | $116.94 | $116.94 |
| Pennsylvania | $116.74 | $116.74 |
| Georgia | $116.31 | $116.31 |
| Oregon | $116.05 | $116.05 |
| Hawaii | $116.03 | $116.03 |
| Puerto Rico | $116.02 | $116.02 |
| Virgin Islands | $116.02 | $116.02 |
| New Hampshire | $115.94 | $115.94 |
| West Virginia | $115.94 | $115.94 |
| Montana | $115.89 | $115.89 |
| Texas | $115.72 | $115.72 |
| Delaware | $115.57 | $115.57 |
| New Mexico | $115.52 | $115.52 |
| Nevada | $114.97 | $114.97 |
| Louisiana | $114.57 | $114.57 |
| Arizona | $114.51 | $114.51 |
| Wyoming | $114.42 | $114.42 |
| Ohio | $114.35 | $114.35 |
| Missouri | $114.30 | $114.30 |
| Utah | $114.22 | $114.22 |
| Virginia | $113.92 | $113.92 |
| South Carolina | $113.65 | $113.65 |
| Kentucky | $113.38 | $113.38 |
| Maine | $112.97 | $112.97 |
| Vermont | $112.91 | $112.91 |
| Oklahoma | $112.67 | $112.67 |
| North Carolina | $112.62 | $112.62 |
| North Dakota | $112.53 | $112.53 |
| Minnesota | $112.44 | $112.44 |
| South Dakota | $112.13 | $112.13 |
| Mississippi | $111.87 | $111.87 |
| Indiana | $111.64 | $111.64 |
| Tennessee | $111.60 | $111.60 |
| Idaho | $111.44 | $111.44 |
| Kansas | $111.32 | $111.32 |
| Wisconsin | $111.20 | $111.20 |
| Alabama | $111.14 | $111.14 |
| Nebraska | $110.95 | $110.95 |
| Iowa | $110.92 | $110.92 |
| Arkansas | $110.56 | $110.56 |

## 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 99478 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