CPT code 99415: Prolonged staff care, first hour, outpatient E/M2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $24.87 for 99415 in the office.

Check a contract rate as a % of Medicare · 99415 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99415 covers

99415 captures prolonged, direct-contact clinical staff work during an office or other outpatient evaluation and management encounter, beyond the time ordinarily associated with that visit. Clinical staff perform the service under physician supervision; the code does not represent extra time personally spent by the physician or other qualified health care professional. It applies when staff remain engaged with the patient during an extended outpatient encounter, rather than for administrative work or unattended waiting time.

Report 99415 with the related office or outpatient E/M primary service. Document the reason for the extension and the clinical staff’s direct-contact time to support the reported service. This is an add-on, paid within the primary service’s global period, not a standalone visit. CMS classifies it as technical-component-only; any separately covered interpretation is represented by its distinct code. Use 99416 for qualifying additional prolonged clinical staff time.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Connecticut compares for 99415

Across 109 of 109 payment localities, the office rate for 99415 runs from $19.68 in Arkansas to $32.93 in San Benito County, CA. Connecticut pays $24.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99415 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 99415 in every payment locality

How the 99415 rate is calculated

Each of 99415’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 99415

The CMS indicators that decide how 99415 is paid alongside other services.

Codes related to 99415

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99415 has changed in Connecticut

Price 99415 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates