CPT code 99415: Prolonged staff care, first hour, outpatient E/M2026 Medicare rate & RVUs in New Mexico
Reports the first-hour add-on for extended direct-contact clinical staff service during an office or outpatient E/M encounter under physician supervision.
In New Mexico, Medicare pays $21.23 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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $21.23. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$21.23
- Los Angeles, CA · California$27.09+$5.86
- Washington, DC area · District of Columbia$27.13+$5.90
- Miami, FL · Florida$24.49+$3.26
- Chicago, IL · Illinois$23.59+$2.36
- Manhattan, NY · New York$26.92+$5.69
- Alaska · Alaska$24.37+$3.14
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $20.06 | — |
| ArkansasArkansas | $19.68 | — |
| ArizonaArizona | $22.29 | — |
| Bakersfield, CACalifornia | $25.10 | — |
| Chico, CACalifornia | $25.07 | — |
| El Centro, CACalifornia | $25.07 | — |
| Fresno, CACalifornia | $25.07 | — |
| Hanford, CACalifornia | $25.07 | — |
| Madera, CACalifornia | $25.07 | — |
| Merced, CACalifornia | $25.07 | — |
| Modesto, CACalifornia | $25.07 | — |
| Napa, CACalifornia | $30.10 | — |
| Oxnard, CACalifornia | $27.05 | — |
| Redding, CACalifornia | $25.07 | — |
| Rest of CaliforniaCalifornia | $25.07 | — |
| Riverside, CACalifornia | $25.18 | — |
| Sacramento, CACalifornia | $26.59 | — |
| Salinas, CACalifornia | $26.50 | — |
| San Diego, CACalifornia | $27.35 | — |
| Marin County, CACalifornia | $32.18 | — |
| San Francisco, CACalifornia | $32.17 | — |
| San Benito County, CACalifornia | $32.93 | — |
| Santa Clara County, CACalifornia | $32.88 | — |
| San Luis Obispo, CACalifornia | $26.05 | — |
| Santa Cruz, CACalifornia | $27.77 | — |
| Santa Maria, CACalifornia | $26.66 | — |
| Santa Rosa, CACalifornia | $28.07 | — |
| Stockton, CACalifornia | $25.07 | — |
| Vallejo, CACalifornia | $30.09 | — |
| Visalia, CACalifornia | $25.07 | — |
| Yuba City, CACalifornia | $25.07 | — |
| ColoradoColorado | $24.43 | — |
| ConnecticutConnecticut | $24.87 | — |
| DelawareDelaware | $22.74 | — |
| Fort Lauderdale, FLFlorida | $23.61 | — |
| Rest of FloridaFlorida | $22.22 | — |
| Atlanta, GAGeorgia | $23.48 | — |
| Rest of GeorgiaGeorgia | $20.66 | — |
| Hawaii, Guam, HIHawaii | $26.02 | — |
| IowaIowa | $20.91 | — |
| IdahoIdaho | $21.05 | — |
| East St. Louis, ILIllinois | $21.57 | — |
| Rest of IllinoisIllinois | $21.26 | — |
| Suburban Chicago, ILIllinois | $23.92 | — |
| IndianaIndiana | $21.22 | — |
| KansasKansas | $20.70 | — |
| KentuckyKentucky | $20.50 | — |
| New Orleans, LALouisiana | $21.75 | — |
| Rest of LouisianaLouisiana | $20.42 | — |
| Metropolitan Boston, MAMassachusetts | $27.42 | — |
| Rest of MassachusettsMassachusetts | $24.18 | — |
| Baltimore area, MDMaryland | $24.78 | — |
| Rest of MarylandMaryland | $23.29 | — |
| Rest of MaineMaine | $21.10 | — |
| Southern Maine, MEMaine | $22.72 | — |
| Detroit, MIMichigan | $22.48 | — |
| Rest of MichiganMichigan | $21.11 | — |
| MinnesotaMinnesota | $23.47 | — |
| Metropolitan Kansas City, MOMissouri | $21.65 | — |
| Metropolitan St. Louis, MOMissouri | $21.96 | — |
| Rest of MissouriMissouri | $19.90 | — |
| MississippiMississippi | $19.80 | — |
| MontanaMontana | $23.05 | — |
| North CarolinaNorth Carolina | $21.40 | — |
| North DakotaNorth Dakota | $22.85 | — |
| NebraskaNebraska | $21.09 | — |
| New HampshireNew Hampshire | $23.94 | — |
| Northern New JerseyNew Jersey | $26.70 | — |
| Rest of New JerseyNew Jersey | $25.17 | — |
| NevadaNevada | $23.01 | — |
| NYC suburbs and Long Island, NYNew York | $27.63 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $25.27 | — |
| Queens, NYNew York | $27.33 | — |
| Rest of New YorkNew York | $21.81 | — |
| OhioOhio | $21.07 | — |
| OklahomaOklahoma | $20.54 | — |
| Portland, OROregon | $25.48 | — |
| Rest of OregonOregon | $22.86 | — |
| Metropolitan Philadelphia, PAPennsylvania | $24.04 | — |
| Rest of PennsylvaniaPennsylvania | $21.17 | — |
| Puerto RicoPuerto Rico | $23.29 | — |
| Rhode IslandRhode Island | $23.76 | — |
| South CarolinaSouth Carolina | $21.27 | — |
| South DakotaSouth Dakota | $22.82 | — |
| TennesseeTennessee | $20.83 | — |
| Austin, TXTexas | $24.33 | — |
| Beaumont, TXTexas | $20.98 | — |
| Brazoria, TXTexas | $22.77 | — |
| Dallas, TXTexas | $22.91 | — |
| Fort Worth, TXTexas | $22.69 | — |
| Galveston, TXTexas | $22.83 | — |
| Houston, TXTexas | $23.01 | — |
| Rest of TexasTexas | $21.86 | — |
| UtahUtah | $21.65 | — |
| VirginiaVirginia | $22.56 | — |
| Virgin Islands, VIUnited States Virgin Islands | $23.29 | — |
| VermontVermont | $22.65 | — |
| Rest of WashingtonWashington | $24.17 | — |
| King County, WAWashington | $28.14 | — |
| WisconsinWisconsin | $21.86 | — |
| West VirginiaWest Virginia | $20.22 | — |
| WyomingWyoming | $22.96 | — |
99415 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$19.68
$29.00
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $24.37 | 1 |
| AL | $20.06 | 1 |
| AR | $19.68 | 1 |
| AZ | $22.29 | 1 |
| CA | $25.07–$32.93 | 29 |
| CO | $24.43 | 1 |
| CT | $24.87 | 1 |
| DC | $27.13 | 1 |
| DE | $22.74 | 1 |
| FL | $22.22–$24.49 | 3 |
| GA | $20.66–$23.48 | 2 |
| GU | $26.02 | 1 |
| HI | $26.02 | 1 |
| IA | $20.91 | 1 |
| ID | $21.05 | 1 |
| IL | $21.26–$23.92 | 4 |
| IN | $21.22 | 1 |
| KS | $20.70 | 1 |
| KY | $20.50 | 1 |
| LA | $20.42–$21.75 | 2 |
| MA | $24.18–$27.42 | 2 |
| MD | $23.29–$27.13 | 3 |
| ME | $21.10–$22.72 | 2 |
| MI | $21.11–$22.48 | 2 |
| MN | $23.47 | 1 |
| MO | $19.90–$21.96 | 3 |
| MS | $19.80 | 1 |
| MT | $23.05 | 1 |
| NC | $21.40 | 1 |
| ND | $22.85 | 1 |
| NE | $21.09 | 1 |
| NH | $23.94 | 1 |
| NJ | $25.17–$26.70 | 2 |
| NM | $21.23 | 1 |
| NV | $23.01 | 1 |
| NY | $21.81–$27.63 | 5 |
| OH | $21.07 | 1 |
| OK | $20.54 | 1 |
| OR | $22.86–$25.48 | 2 |
| PA | $21.17–$24.04 | 2 |
| PR | $23.29 | 1 |
| RI | $23.76 | 1 |
| SC | $21.27 | 1 |
| SD | $22.82 | 1 |
| TN | $20.83 | 1 |
| TX | $20.98–$24.33 | 8 |
| UT | $21.65 | 1 |
| VA | $22.56–$27.13 | 2 |
| VI | $23.29 | 1 |
| VT | $22.65 | 1 |
| WA | $24.17–$28.14 | 2 |
| WI | $21.86 | 1 |
| WV | $20.22 | 1 |
| WY | $22.96 | 1 |
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.
How the rate is built · 99415
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.68
0.68 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.6900
Conversion factor
$33.4009
Medicare rate
$23.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,098
- Code
- 99415
- Physician work
- 0.00
- Practice expense
- 0.68
- Malpractice
- 0.01
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 0.68 | × 0.917 | 0.6236 |
| Malpractice | 0.01 | × 1.201 | 0.0120 |
| Total RVUs | 0.6356 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$21.23
Office: (0 × 1 + 0.68 × 0.917 + 0.01 × 1.201) × $33.4009 = $21.23
Payment rules and modifiers for 99415
The CMS indicators that decide how 99415 is paid alongside other services.
CMS payment indicators · 99415
Prolonged staff care, first hour, outpatient E/M
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
How 99415 has changed in New Mexico
99415 · Office / nonfacility
$21.23
Effective 2026-10-01
The base rate is $2.93 higher than on 2025-10-01, moving from $18.30 to $21.23 (16.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$18.30changed to$21.23
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.61 changed to 0.68
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$18.92changed to$18.30
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.60 changed to 0.61
- Malpractice RVU 0.02 changed to 0.01
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$18.61changed to$18.92
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$17.21changed to$18.61
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.55 changed to 0.60
- Malpractice RVU 0.01 changed to 0.02
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$9.40changed to$17.21
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.29 changed to 0.55
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$9.16changed to$9.40
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.28 changed to 0.29
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$9.28changed to$9.16
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.27 changed to 0.28
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$9.41changed to$9.28
- Conversion factor 36.0391 changed to 36.0896
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$9.40changed to$9.41
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$8.36changed to$9.40
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.24 changed to 0.27
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$8.31changed to$8.36
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$8.31
Held through RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $21.23 | Not available in this setting | RVU26D |
| 2026-07-01 | $21.23 | Not available in this setting | RVU26C |
| 2026-04-01 | $21.23 | Not available in this setting | RVU26B |
| 2026-01-01 | $21.23 | Not available in this setting | RVU26A |
| 2025-10-01 | $18.30 | Not available in this setting | RVU25D |
| 2025-07-01 | $18.30 | Not available in this setting | RVU25C |
| 2025-04-01 | $18.30 | Not available in this setting | RVU25B |
| 2025-01-01 | $18.30 | Not available in this setting | RVU25A |
| 2024-10-01 | $18.92 | Not available in this setting | RVU24D |
| 2024-07-01 | $18.92 | Not available in this setting | RVU24C |
| 2024-04-01 | $18.92 | Not available in this setting | RVU24B |
| 2024-03-09 | $18.92 | Not available in this setting | RVU24AR |
| 2024-01-01 | $18.61 | Not available in this setting | RVU24A |
| 2023-10-01 | $17.21 | Not available in this setting | RVU23D |
| 2023-07-01 | $17.21 | Not available in this setting | RVU23C |
| 2023-04-01 | $17.21 | Not available in this setting | RVU23B |
| 2023-01-01 | $17.21 | Not available in this setting | RVU23A |
| 2022-10-01 | $9.40 | Not available in this setting | RVU22D |
| 2022-07-01 | $9.40 | Not available in this setting | RVU22C |
| 2022-04-01 | $9.40 | Not available in this setting | RVU22B |
| 2022-01-01 | $9.40 | Not available in this setting | RVU22A |
| 2021-10-01 | $9.16 | Not available in this setting | RVU21D |
| 2021-07-01 | $9.16 | Not available in this setting | RVU21C |
| 2021-04-01 | $9.16 | Not available in this setting | RVU21B |
| 2021-01-01 | $9.16 | Not available in this setting | RVU21A |
| 2020-10-01 | $9.28 | Not available in this setting | RVU20D |
| 2020-07-01 | $9.28 | Not available in this setting | RVU20C |
| 2020-04-01 | $9.28 | Not available in this setting | RVU20B |
| 2020-01-01 | $9.28 | Not available in this setting | RVU20A |
| 2019-10-01 | $9.41 | Not available in this setting | RVU19D |
| 2019-07-01 | $9.41 | Not available in this setting | RVU19C |
| 2019-04-01 | $9.41 | Not available in this setting | RVU19B |
| 2019-01-01 | $9.41 | Not available in this setting | RVU19A |
| 2018-10-01 | $9.40 | Not available in this setting | RVU18D |
| 2018-07-01 | $9.40 | Not available in this setting | RVU18C |
| 2018-04-01 | $9.40 | Not available in this setting | RVU18B |
| 2018-01-01 | $9.40 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $8.36 | Not available in this setting | RVU17D |
| 2017-07-01 | $8.36 | Not available in this setting | RVU17C |
| 2017-04-01 | $8.36 | Not available in this setting | RVU17B |
| 2017-01-01 | $8.36 | Not available in this setting | RVU17A |
| 2016-10-01 | $8.31 | $8.31 | RVU16D |
| 2016-07-01 | $8.31 | $8.31 | RVU16C |
| 2016-04-01 | $8.31 | $8.31 | RVU16B |
| 2016-01-01 | $8.31 | $8.31 | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
99415 billing questions
When should I choose 99415 instead of 99417?
Use 99415 for prolonged direct-contact time furnished by clinical staff during an office or outpatient E/M encounter. 99417 describes prolonged time attributable to the E/M professional, not the clinical staff service.
What primary service must accompany 99415?
Report it with the related office or outpatient E/M service as an add-on. CMS pays it within that primary service’s global period.
Can I report 99415 for staff documentation or waiting time?
The service is for prolonged direct patient contact by clinical staff under physician supervision. Administrative documentation or time when staff are not engaged directly with the patient does not establish that service.
How do I report additional prolonged staff time?
99415 represents the first-hour add-on. Report 99416 for qualifying additional prolonged clinical staff time, supported by documentation of the direct-contact service and its duration.
Does 99415 represent the interpretation component?
CMS classifies 99415 as technical-component-only. A separately covered interpretation is represented by its distinct code.
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
Show the CMS file lines behind this rate
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