CPT code 99423: Online E/M, 21 or more minutes2026 Medicare rate & RVUs in Indiana
Reports an established-patient, patient-initiated online evaluation and management episode when the qualified professional’s cumulative work reaches 21 minutes.
In Indiana, Medicare pays $46.42 for 99423 in the office and $33.72 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99423 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 99423 covers
A physician or other qualified health professional reviews patient-initiated messages through a secure online portal, assesses a concern, and responds with clinical advice, orders, or a treatment plan. The service is for an established patient whose issue can be handled asynchronously rather than through a real-time visit. Professional work can include reviewing relevant records and composing the clinical response; staff-only message handling is not the professional service represented by this code.
Select this level when the professional’s cumulative time for the online E/M episode is 21 minutes or more within seven days. Do not count each message as a separate service: document the patient’s request, dates of work, clinical assessment and response, and total professional minutes for the episode. CMS fee schedule valuation includes work and malpractice RVUs, with separate office and facility practice-expense inputs.
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 Indiana compares for 99423
Across 109 of 109 payment localities, the office rate for 99423 runs from $45.08 in Arkansas to $62.70 in Alaska. Indiana pays $46.42. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Indiana · this page$46.42
- Los Angeles, CA · California$53.03+$6.61
- Washington, DC area · District of Columbia$54.02+$7.60
- Miami, FL · Florida$52.15+$5.73
- Chicago, IL · Illinois$51.22+$4.80
- Manhattan, NY · New York$54.75+$8.33
- Alaska · Alaska$62.70+$16.28
Other areas in Indiana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $45.49 | $33.51 |
| ArkansasArkansas | $45.08 | $33.32 |
| ArizonaArizona | $47.89 | $34.62 |
| Bakersfield, CACalifornia | $50.58 | $35.57 |
| Chico, CACalifornia | $50.40 | $35.39 |
| El Centro, CACalifornia | $50.41 | $35.40 |
| Fresno, CACalifornia | $50.40 | $35.39 |
| Hanford, CACalifornia | $50.40 | $35.39 |
| Madera, CACalifornia | $50.40 | $35.39 |
| Merced, CACalifornia | $50.40 | $35.39 |
| Modesto, CACalifornia | $50.40 | $35.39 |
| Napa, CACalifornia | $56.11 | $38.06 |
| Oxnard, CACalifornia | $52.59 | $36.41 |
| Redding, CACalifornia | $50.40 | $35.39 |
| Rest of CaliforniaCalifornia | $50.40 | $35.39 |
| Riverside, CACalifornia | $50.96 | $35.95 |
| Sacramento, CACalifornia | $52.27 | $36.35 |
| Salinas, CACalifornia | $52.06 | $36.19 |
| San Diego, CACalifornia | $52.80 | $36.42 |
| Marin County, CACalifornia | $58.75 | $39.44 |
| San Francisco, CACalifornia | $58.70 | $39.39 |
| San Benito County, CACalifornia | $59.94 | $40.19 |
| Santa Clara County, CACalifornia | $59.70 | $39.96 |
| San Luis Obispo, CACalifornia | $51.28 | $35.68 |
| Santa Cruz, CACalifornia | $52.93 | $36.29 |
| Santa Maria, CACalifornia | $52.12 | $36.15 |
| Santa Rosa, CACalifornia | $53.44 | $36.62 |
| Stockton, CACalifornia | $50.40 | $35.39 |
| Vallejo, CACalifornia | $56.02 | $37.98 |
| Visalia, CACalifornia | $50.40 | $35.39 |
| Yuba City, CACalifornia | $50.40 | $35.39 |
| ColoradoColorado | $50.02 | $35.45 |
| ConnecticutConnecticut | $51.22 | $36.47 |
| DelawareDelaware | $48.49 | $34.96 |
| Fort Lauderdale, FLFlorida | $50.38 | $36.51 |
| Rest of FloridaFlorida | $48.71 | $35.62 |
| Atlanta, GAGeorgia | $49.51 | $35.59 |
| Rest of GeorgiaGeorgia | $46.89 | $34.67 |
| Hawaii, Guam, HIHawaii | $50.85 | $35.28 |
| IowaIowa | $46.03 | $33.50 |
| IdahoIdaho | $46.26 | $33.66 |
| East St. Louis, ILIllinois | $48.83 | $36.23 |
| Rest of IllinoisIllinois | $47.93 | $35.43 |
| Suburban Chicago, ILIllinois | $50.79 | $36.73 |
| KansasKansas | $45.98 | $33.60 |
| KentuckyKentucky | $46.36 | $34.19 |
| New Orleans, LALouisiana | $47.79 | $34.90 |
| Rest of LouisianaLouisiana | $46.35 | $34.23 |
| Metropolitan Boston, MAMassachusetts | $53.63 | $37.28 |
| Rest of MassachusettsMassachusetts | $49.93 | $35.51 |
| Baltimore area, MDMaryland | $51.08 | $36.38 |
| Rest of MarylandMaryland | $49.14 | $35.28 |
| Rest of MaineMaine | $46.50 | $33.91 |
| Southern Maine, MEMaine | $47.97 | $34.39 |
| Detroit, MIMichigan | $49.20 | $35.98 |
| Rest of MichiganMichigan | $47.21 | $34.71 |
| MinnesotaMinnesota | $48.18 | $34.09 |
| Metropolitan Kansas City, MOMissouri | $47.48 | $34.63 |
| Metropolitan St. Louis, MOMissouri | $47.79 | $34.75 |
| Rest of MissouriMissouri | $45.91 | $34.11 |
| MississippiMississippi | $45.50 | $33.71 |
| MontanaMontana | $48.76 | $35.07 |
| North CarolinaNorth Carolina | $46.80 | $34.02 |
| North DakotaNorth Dakota | $47.77 | $34.08 |
| NebraskaNebraska | $46.16 | $33.52 |
| New HampshireNew Hampshire | $49.39 | $35.14 |
| Northern New JerseyNew Jersey | $53.82 | $37.94 |
| Rest of New JerseyNew Jersey | $51.87 | $36.92 |
| New MexicoNew Mexico | $47.41 | $34.85 |
| NevadaNevada | $48.51 | $34.80 |
| NYC suburbs and Long Island, NYNew York | $55.76 | $39.47 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $52.25 | $37.26 |
| Queens, NYNew York | $54.92 | $38.74 |
| Rest of New YorkNew York | $47.25 | $34.24 |
| OhioOhio | $47.01 | $34.50 |
| OklahomaOklahoma | $46.21 | $33.98 |
| Portland, OROregon | $51.03 | $35.81 |
| Rest of OregonOregon | $48.19 | $34.55 |
| Metropolitan Philadelphia, PAPennsylvania | $50.40 | $36.15 |
| Rest of PennsylvaniaPennsylvania | $47.00 | $34.43 |
| Puerto RicoPuerto Rico | $48.96 | $35.12 |
| Rhode IslandRhode Island | $49.77 | $35.62 |
| South CarolinaSouth Carolina | $46.97 | $34.31 |
| South DakotaSouth Dakota | $47.66 | $33.96 |
| TennesseeTennessee | $46.14 | $33.69 |
| Austin, TXTexas | $49.81 | $35.32 |
| Beaumont, TXTexas | $46.81 | $34.35 |
| Brazoria, TXTexas | $48.43 | $34.86 |
| Dallas, TXTexas | $48.69 | $35.05 |
| Fort Worth, TXTexas | $48.51 | $35.00 |
| Galveston, TXTexas | $48.55 | $34.95 |
| Houston, TXTexas | $49.46 | $35.87 |
| Rest of TexasTexas | $47.56 | $34.57 |
| UtahUtah | $47.37 | $34.50 |
| VirginiaVirginia | $47.93 | $34.47 |
| Virgin Islands, VIUnited States Virgin Islands | $48.96 | $35.12 |
| VermontVermont | $47.74 | $34.18 |
| Rest of WashingtonWashington | $49.79 | $35.37 |
| King County, WAWashington | $54.42 | $37.62 |
| WisconsinWisconsin | $46.75 | $33.63 |
| West VirginiaWest Virginia | $46.82 | $34.92 |
| WyomingWyoming | $48.33 | $34.64 |
99423 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.
$45.08
$62.70
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 | $62.70 | 1 |
| AL | $45.49 | 1 |
| AR | $45.08 | 1 |
| AZ | $47.89 | 1 |
| CA | $50.40–$59.94 | 29 |
| CO | $50.02 | 1 |
| CT | $51.22 | 1 |
| DC | $54.02 | 1 |
| DE | $48.49 | 1 |
| FL | $48.71–$52.15 | 3 |
| GA | $46.89–$49.51 | 2 |
| GU | $50.85 | 1 |
| HI | $50.85 | 1 |
| IA | $46.03 | 1 |
| ID | $46.26 | 1 |
| IL | $47.93–$51.22 | 4 |
| IN | $46.42 | 1 |
| KS | $45.98 | 1 |
| KY | $46.36 | 1 |
| LA | $46.35–$47.79 | 2 |
| MA | $49.93–$53.63 | 2 |
| MD | $49.14–$54.02 | 3 |
| ME | $46.50–$47.97 | 2 |
| MI | $47.21–$49.20 | 2 |
| MN | $48.18 | 1 |
| MO | $45.91–$47.79 | 3 |
| MS | $45.50 | 1 |
| MT | $48.76 | 1 |
| NC | $46.80 | 1 |
| ND | $47.77 | 1 |
| NE | $46.16 | 1 |
| NH | $49.39 | 1 |
| NJ | $51.87–$53.82 | 2 |
| NM | $47.41 | 1 |
| NV | $48.51 | 1 |
| NY | $47.25–$55.76 | 5 |
| OH | $47.01 | 1 |
| OK | $46.21 | 1 |
| OR | $48.19–$51.03 | 2 |
| PA | $47.00–$50.40 | 2 |
| PR | $48.96 | 1 |
| RI | $49.77 | 1 |
| SC | $46.97 | 1 |
| SD | $47.66 | 1 |
| TN | $46.14 | 1 |
| TX | $46.81–$49.81 | 8 |
| UT | $47.37 | 1 |
| VA | $47.93–$54.02 | 2 |
| VI | $48.96 | 1 |
| VT | $47.74 | 1 |
| WA | $49.79–$54.42 | 2 |
| WI | $46.75 | 1 |
| WV | $46.82 | 1 |
| WY | $48.33 | 1 |
How the 99423 rate is calculated
Each of 99423’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 · 99423
RVUs × geographic indexes × conversion factor
Work0.80
0.80 RVUs× 1.000 GPCI
Practice expense0.61
0.61 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.4600
Conversion factor
$33.4009
Medicare rate
$48.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Indiana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,104
- Code
- 99423
- Physician work
- 0.80
- Practice expense
- 0.61
- Malpractice
- 0.05
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.80 | × 1.000 | 0.8000 |
| Practice expense | 0.61 | × 0.927 | 0.5655 |
| Malpractice | 0.05 | × 0.486 | 0.0243 |
| Total RVUs | 1.3898 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Indiana$46.42
Office: (0.8 × 1 + 0.61 × 0.927 + 0.05 × 0.486) × $33.4009 = $46.42
Facility: (0.8 × 1 + 0.2 × 0.927 + 0.05 × 0.486) × $33.4009 = $33.72
Payment rules and modifiers for 99423
99423 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 99423
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$48.77
- Non-facility (office)
- $48.77
- Facility
- $35.07
Higher because the practice carries its own overhead.
How 99423 has changed in Indiana
99423 · Office / nonfacility
$46.42
Effective 2026-10-01
The base rate is $3.51 higher than on 2025-10-01, moving from $42.91 to $46.42 (8.2%).
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
$42.91changed to$46.42
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.55 changed to 0.61
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.922 changed to 0.927
- Malpractice GPCI 0.485 changed to 0.486
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$44.17changed to$42.91
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.54 changed to 0.55
- Malpractice RVU 0.06 changed to 0.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$43.45changed to$44.17
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$44.44changed to$43.45
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.53 changed to 0.54
- Practice expense GPCI 0.911 changed to 0.922
- Malpractice GPCI 0.475 changed to 0.485
January 1, 2023
RVU23A
$45.32changed to$44.44
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.07 changed to 0.06
- Practice expense GPCI 0.900 changed to 0.911
- Malpractice GPCI 0.465 changed to 0.475
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$44.74changed to$45.32
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.51 changed to 0.53
- Malpractice RVU 0.05 changed to 0.07
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$46.84changed to$44.74
- Conversion factor 36.0896 changed to 34.8931
- Malpractice RVU 0.08 changed to 0.05
- Practice expense GPCI 0.910 changed to 0.900
- Malpractice GPCI 0.422 changed to 0.465
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$46.84
Held through RVU20B, RVU20C, RVU20D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $46.42 | $33.72 | RVU26D |
| 2026-07-01 | $46.42 | $33.72 | RVU26C |
| 2026-04-01 | $46.42 | $33.72 | RVU26B |
| 2026-01-01 | $46.42 | $33.72 | RVU26A |
| 2025-10-01 | $42.91 | $36.64 | RVU25D |
| 2025-07-01 | $42.91 | $36.64 | RVU25C |
| 2025-04-01 | $42.91 | $36.64 | RVU25B |
| 2025-01-01 | $42.91 | $36.64 | RVU25A |
| 2024-10-01 | $44.17 | $38.03 | RVU24D |
| 2024-07-01 | $44.17 | $38.03 | RVU24C |
| 2024-04-01 | $44.17 | $38.03 | RVU24B |
| 2024-03-09 | $44.17 | $38.03 | RVU24AR |
| 2024-01-01 | $43.45 | $37.41 | RVU24A |
| 2023-10-01 | $44.44 | $38.26 | RVU23D |
| 2023-07-01 | $44.44 | $38.26 | RVU23C |
| 2023-04-01 | $44.44 | $38.26 | RVU23B |
| 2023-01-01 | $44.44 | $38.26 | RVU23A |
| 2022-10-01 | $45.32 | $39.40 | RVU22D |
| 2022-07-01 | $45.32 | $39.40 | RVU22C |
| 2022-04-01 | $45.32 | $39.40 | RVU22B |
| 2022-01-01 | $45.32 | $39.40 | RVU22A |
| 2021-10-01 | $44.74 | $39.09 | RVU21D |
| 2021-07-01 | $44.74 | $39.09 | RVU21C |
| 2021-04-01 | $44.74 | $39.09 | RVU21B |
| 2021-01-01 | $44.74 | $39.09 | RVU21A |
| 2020-10-01 | $46.84 | $40.93 | RVU20D |
| 2020-07-01 | $46.84 | $40.93 | RVU20C |
| 2020-04-01 | $46.84 | $40.93 | RVU20B |
| 2020-01-01 | $46.84 | $40.93 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | 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 Indiana rate applies
Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Abington
- Adams
- Adams Lake
- Advance
- Akron
- Alamo
- Albany
99423 billing questions
How does 99423 differ from 99422?
Both represent patient-initiated online E/M for an established patient. Choose 99423 when cumulative professional time reaches 21 minutes or more within seven days; 99422 is for 11 through 20 minutes.
Can each portal message be billed separately?
No. Treat the work as a seven-day episode and select the level using the cumulative professional time, even when the exchange includes multiple messages.
What time should be documented?
Document the qualified professional’s total time spent on the online evaluation and management work during the seven-day period. The record should also show the patient’s request, the clinical issue, and the resulting assessment and response.
Can clinical staff time support 99423?
The code represents the physician’s or other qualified health professional’s online E/M work. Staff-only message handling does not establish the professional time for this level.
When should 99421 be selected instead?
Use 99421 for the same type of online E/M episode when cumulative professional time is 5 through 10 minutes. The time threshold, not the number of messages, distinguishes the level.
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
Fee sheets · Coming soon
Put 99423 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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