CPT code 99416: Prolonged staff service, each additional time unit2026 Medicare rate & RVUs in Montana
Report 99416 for additional prolonged clinical staff time furnished under physician or qualified health care professional supervision with a qualifying office or outpatient E/M service.
In Montana, Medicare pays $12.69 for 99416 in the office.
Check a contract rate as a % of Medicare · 99416 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 99416 covers
99416 represents additional time spent by clinical staff extending an office or outpatient evaluation and management service. It is used after the initial prolonged clinical staff service represented by 99415, when staff continue care under a physician’s or other qualified health care professional’s supervision. The work may occur in an office or outpatient setting; the claim must connect the staff time to the qualifying E/M encounter rather than to unrelated administrative work.
Report 99416 only with its required primary service, including 99415 for the initial prolonged staff service. Document the staff members involved, the supervised clinical work, and the additional time attributable to the encounter so the units billed are supported. CMS classifies this code as technical-component-only, with interpretation covered by a separate code. Payment is made within the primary procedure’s global period, so the add-on is not billed as a standalone service.
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 Montana compares for 99416
Across 109 of 109 payment localities, the office rate for 99416 runs from $10.79 in Arkansas to $18.00 in San Benito County, CA. Montana pays $12.69. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$12.69
- Los Angeles, CA · California$14.84+$2.15
- Washington, DC area · District of Columbia$14.93+$2.24
- Miami, FL · Florida$13.71+$1.02
- Chicago, IL · Illinois$13.19+$0.50
- Manhattan, NY · New York$14.89+$2.20
- Alaska · Alaska$13.35+$0.66
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $11.00 | — |
| ArkansasArkansas | $10.79 | — |
| ArizonaArizona | $12.26 | — |
| Bakersfield, CACalifornia | $13.75 | — |
| Chico, CACalifornia | $13.72 | — |
| El Centro, CACalifornia | $13.73 | — |
| Fresno, CACalifornia | $13.72 | — |
| Hanford, CACalifornia | $13.72 | — |
| Madera, CACalifornia | $13.72 | — |
| Merced, CACalifornia | $13.72 | — |
| Modesto, CACalifornia | $13.72 | — |
| Napa, CACalifornia | $16.46 | — |
| Oxnard, CACalifornia | $14.82 | — |
| Redding, CACalifornia | $13.72 | — |
| Rest of CaliforniaCalifornia | $13.72 | — |
| Riverside, CACalifornia | $13.83 | — |
| Sacramento, CACalifornia | $14.55 | — |
| Salinas, CACalifornia | $14.50 | — |
| San Diego, CACalifornia | $14.96 | — |
| Marin County, CACalifornia | $17.58 | — |
| San Francisco, CACalifornia | $17.57 | — |
| San Benito County, CACalifornia | $18.00 | — |
| Santa Clara County, CACalifornia | $17.95 | — |
| San Luis Obispo, CACalifornia | $14.26 | — |
| Santa Cruz, CACalifornia | $15.19 | — |
| Santa Maria, CACalifornia | $14.59 | — |
| Santa Rosa, CACalifornia | $15.36 | — |
| Stockton, CACalifornia | $13.72 | — |
| Vallejo, CACalifornia | $16.44 | — |
| Visalia, CACalifornia | $13.72 | — |
| Yuba City, CACalifornia | $13.72 | — |
| ColoradoColorado | $13.41 | — |
| ConnecticutConnecticut | $13.71 | — |
| DelawareDelaware | $12.51 | — |
| Fort Lauderdale, FLFlorida | $13.12 | — |
| Rest of FloridaFlorida | $12.32 | — |
| Atlanta, GAGeorgia | $12.96 | — |
| Rest of GeorgiaGeorgia | $11.42 | — |
| Hawaii, Guam, HIHawaii | $14.24 | — |
| IowaIowa | $11.44 | — |
| IdahoIdaho | $11.53 | — |
| East St. Louis, ILIllinois | $12.04 | — |
| Rest of IllinoisIllinois | $11.81 | — |
| Suburban Chicago, ILIllinois | $13.28 | — |
| IndianaIndiana | $11.62 | — |
| KansasKansas | $11.34 | — |
| KentuckyKentucky | $11.29 | — |
| New Orleans, LALouisiana | $12.01 | — |
| Rest of LouisianaLouisiana | $11.26 | — |
| Metropolitan Boston, MAMassachusetts | $15.05 | — |
| Rest of MassachusettsMassachusetts | $13.28 | — |
| Baltimore area, MDMaryland | $13.67 | — |
| Rest of MarylandMaryland | $12.81 | — |
| Rest of MaineMaine | $11.58 | — |
| Southern Maine, MEMaine | $12.46 | — |
| Detroit, MIMichigan | $12.49 | — |
| Rest of MichiganMichigan | $11.66 | — |
| MinnesotaMinnesota | $12.82 | — |
| Metropolitan Kansas City, MOMissouri | $11.93 | — |
| Metropolitan St. Louis, MOMissouri | $12.10 | — |
| Rest of MissouriMissouri | $10.98 | — |
| MississippiMississippi | $10.89 | — |
| North CarolinaNorth Carolina | $11.74 | — |
| North DakotaNorth Dakota | $12.49 | — |
| NebraskaNebraska | $11.53 | — |
| New HampshireNew Hampshire | $13.16 | — |
| Northern New JerseyNew Jersey | $14.69 | — |
| Rest of New JerseyNew Jersey | $13.86 | — |
| New MexicoNew Mexico | $11.73 | — |
| NevadaNevada | $12.65 | — |
| NYC suburbs and Long Island, NYNew York | $15.31 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $13.94 | — |
| Queens, NYNew York | $15.09 | — |
| Rest of New YorkNew York | $11.98 | — |
| OhioOhio | $11.62 | — |
| OklahomaOklahoma | $11.30 | — |
| Portland, OROregon | $13.98 | — |
| Rest of OregonOregon | $12.54 | — |
| Metropolitan Philadelphia, PAPennsylvania | $13.26 | — |
| Rest of PennsylvaniaPennsylvania | $11.66 | — |
| Puerto RicoPuerto Rico | $12.82 | — |
| Rhode IslandRhode Island | $13.06 | — |
| South CarolinaSouth Carolina | $11.70 | — |
| South DakotaSouth Dakota | $12.47 | — |
| TennesseeTennessee | $11.41 | — |
| Austin, TXTexas | $13.37 | — |
| Beaumont, TXTexas | $11.56 | — |
| Brazoria, TXTexas | $12.51 | — |
| Dallas, TXTexas | $12.60 | — |
| Fort Worth, TXTexas | $12.48 | — |
| Galveston, TXTexas | $12.55 | — |
| Houston, TXTexas | $12.73 | — |
| Rest of TexasTexas | $12.03 | — |
| UtahUtah | $11.92 | — |
| VirginiaVirginia | $12.38 | — |
| Virgin Islands, VIUnited States Virgin Islands | $12.82 | — |
| VermontVermont | $12.40 | — |
| Rest of WashingtonWashington | $13.27 | — |
| King County, WAWashington | $15.44 | — |
| WisconsinWisconsin | $11.94 | — |
| West VirginiaWest Virginia | $11.22 | — |
| WyomingWyoming | $12.61 | — |
99416 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.
$10.79
$15.86
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 | $13.35 | 1 |
| AL | $11.00 | 1 |
| AR | $10.79 | 1 |
| AZ | $12.26 | 1 |
| CA | $13.72–$18.00 | 29 |
| CO | $13.41 | 1 |
| CT | $13.71 | 1 |
| DC | $14.93 | 1 |
| DE | $12.51 | 1 |
| FL | $12.32–$13.71 | 3 |
| GA | $11.42–$12.96 | 2 |
| GU | $14.24 | 1 |
| HI | $14.24 | 1 |
| IA | $11.44 | 1 |
| ID | $11.53 | 1 |
| IL | $11.81–$13.28 | 4 |
| IN | $11.62 | 1 |
| KS | $11.34 | 1 |
| KY | $11.29 | 1 |
| LA | $11.26–$12.01 | 2 |
| MA | $13.28–$15.05 | 2 |
| MD | $12.81–$14.93 | 3 |
| ME | $11.58–$12.46 | 2 |
| MI | $11.66–$12.49 | 2 |
| MN | $12.82 | 1 |
| MO | $10.98–$12.10 | 3 |
| MS | $10.89 | 1 |
| MT | $12.69 | 1 |
| NC | $11.74 | 1 |
| ND | $12.49 | 1 |
| NE | $11.53 | 1 |
| NH | $13.16 | 1 |
| NJ | $13.86–$14.69 | 2 |
| NM | $11.73 | 1 |
| NV | $12.65 | 1 |
| NY | $11.98–$15.31 | 5 |
| OH | $11.62 | 1 |
| OK | $11.30 | 1 |
| OR | $12.54–$13.98 | 2 |
| PA | $11.66–$13.26 | 2 |
| PR | $12.82 | 1 |
| RI | $13.06 | 1 |
| SC | $11.70 | 1 |
| SD | $12.47 | 1 |
| TN | $11.41 | 1 |
| TX | $11.56–$13.37 | 8 |
| UT | $11.92 | 1 |
| VA | $12.38–$14.93 | 2 |
| VI | $12.82 | 1 |
| VT | $12.40 | 1 |
| WA | $13.27–$15.44 | 2 |
| WI | $11.94 | 1 |
| WV | $11.22 | 1 |
| WY | $12.61 | 1 |
How the 99416 rate is calculated
Each of 99416’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 · 99416
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.37
0.37 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.3800
Conversion factor
$33.4009
Medicare rate
$12.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,099
- Code
- 99416
- Physician work
- 0.00
- Practice expense
- 0.37
- Malpractice
- 0.01
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 0.37 | × 1.000 | 0.3700 |
| Malpractice | 0.01 | × 0.998 | 0.0100 |
| Total RVUs | 0.3800 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$12.69
Office: (0 × 1 + 0.37 × 1 + 0.01 × 0.998) × $33.4009 = $12.69
Payment rules and modifiers for 99416
The CMS indicators that decide how 99416 is paid alongside other services.
CMS payment indicators · 99416
Prolonged staff service, each additional time unit
| 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 99416 has changed in Montana
99416 · Office / nonfacility
$12.69
Effective 2026-10-01
The base rate is $3.32 higher than on 2025-10-01, moving from $9.37 to $12.69 (35.4%).
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
$9.37changed to$12.69
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.28 changed to 0.37
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$9.65changed to$9.37
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$9.49changed to$9.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$8.80changed to$9.49
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.25 changed to 0.28
January 1, 2023
RVU23A
$5.88changed to$8.80
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.17 changed to 0.25
- Malpractice RVU 0.00 changed to 0.01
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$5.23changed to$5.88
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.15 changed to 0.17
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$4.33changed to$5.23
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.12 changed to 0.15
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$4.32changed to$4.33
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$4.68changed to$4.32
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.13 changed to 0.12
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$4.67changed to$4.68
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$5.09changed to$4.67
- Conversion factor 35.8043 changed to 35.8887
- Malpractice RVU 0.01 changed to 0.00
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$5.09
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 | $12.69 | Not available in this setting | RVU26D |
| 2026-07-01 | $12.69 | Not available in this setting | RVU26C |
| 2026-04-01 | $12.69 | Not available in this setting | RVU26B |
| 2026-01-01 | $12.69 | Not available in this setting | RVU26A |
| 2025-10-01 | $9.37 | Not available in this setting | RVU25D |
| 2025-07-01 | $9.37 | Not available in this setting | RVU25C |
| 2025-04-01 | $9.37 | Not available in this setting | RVU25B |
| 2025-01-01 | $9.37 | Not available in this setting | RVU25A |
| 2024-10-01 | $9.65 | Not available in this setting | RVU24D |
| 2024-07-01 | $9.65 | Not available in this setting | RVU24C |
| 2024-04-01 | $9.65 | Not available in this setting | RVU24B |
| 2024-03-09 | $9.65 | Not available in this setting | RVU24AR |
| 2024-01-01 | $9.49 | Not available in this setting | RVU24A |
| 2023-10-01 | $8.80 | Not available in this setting | RVU23D |
| 2023-07-01 | $8.80 | Not available in this setting | RVU23C |
| 2023-04-01 | $8.80 | Not available in this setting | RVU23B |
| 2023-01-01 | $8.80 | Not available in this setting | RVU23A |
| 2022-10-01 | $5.88 | Not available in this setting | RVU22D |
| 2022-07-01 | $5.88 | Not available in this setting | RVU22C |
| 2022-04-01 | $5.88 | Not available in this setting | RVU22B |
| 2022-01-01 | $5.88 | Not available in this setting | RVU22A |
| 2021-10-01 | $5.23 | Not available in this setting | RVU21D |
| 2021-07-01 | $5.23 | Not available in this setting | RVU21C |
| 2021-04-01 | $5.23 | Not available in this setting | RVU21B |
| 2021-01-01 | $5.23 | Not available in this setting | RVU21A |
| 2020-10-01 | $4.33 | Not available in this setting | RVU20D |
| 2020-07-01 | $4.33 | Not available in this setting | RVU20C |
| 2020-04-01 | $4.33 | Not available in this setting | RVU20B |
| 2020-01-01 | $4.33 | Not available in this setting | RVU20A |
| 2019-10-01 | $4.32 | Not available in this setting | RVU19D |
| 2019-07-01 | $4.32 | Not available in this setting | RVU19C |
| 2019-04-01 | $4.32 | Not available in this setting | RVU19B |
| 2019-01-01 | $4.32 | Not available in this setting | RVU19A |
| 2018-10-01 | $4.68 | Not available in this setting | RVU18D |
| 2018-07-01 | $4.68 | Not available in this setting | RVU18C |
| 2018-04-01 | $4.68 | Not available in this setting | RVU18B |
| 2018-01-01 | $4.68 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $4.67 | Not available in this setting | RVU17D |
| 2017-07-01 | $4.67 | Not available in this setting | RVU17C |
| 2017-04-01 | $4.67 | Not available in this setting | RVU17B |
| 2017-01-01 | $4.67 | Not available in this setting | RVU17A |
| 2016-10-01 | $5.09 | $5.09 | RVU16D |
| 2016-07-01 | $5.09 | $5.09 | RVU16C |
| 2016-04-01 | $5.09 | $5.09 | RVU16B |
| 2016-01-01 | $5.09 | $5.09 | 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 Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
99416 billing questions
When should 99416 be used instead of 99415?
99415 represents the initial prolonged clinical staff service; 99416 represents additional prolonged staff time. Report 99416 only after the initial service is supported and with the required primary code.
Can 99416 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure, typically 99415 for the initial prolonged clinical staff service.
What time should the record support?
Document the additional clinical staff time spent on the encounter, the work performed, and the supervising physician or qualified health care professional. The documentation should support each unit reported.
Is 99416 a physician professional service?
CMS classifies 99416 as technical-component-only and indicates that interpretation is covered separately. The record for this code should establish the clinical staff service and its supervision.
How does 99416 differ from 99417?
99416 represents additional prolonged time furnished by clinical staff. 99417 represents prolonged office or outpatient E/M time furnished by the physician or other qualified health care professional.
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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