CPT code 99427: Principal care management, additional clinical staff time2026 Medicare rate & RVUs in Arkansas
Reports each additional 30 minutes of clinical staff principal care management for a patient with a serious, complex chronic condition during a calendar month.
In Arkansas, Medicare pays $49.25 for 99427 in the office and $29.74 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99427 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 99427 covers
This code covers an additional 30 minutes of clinical staff work in principal care management for a patient with a single serious, complex chronic condition. The work centers on the condition-specific care plan and may include coordinating care with other clinicians, supporting medication management, and following up on changes that affect the patient’s disease. Clinical staff perform the work under a physician’s or other qualified health care professional’s direction, commonly as part of outpatient care for a condition that creates substantial risk of worsening or functional decline.
Report 99427 only after the initial clinical staff principal care management interval is represented by 99426. The record should identify the condition and care plan, describe the staff activities, and support the additional time counted during the calendar month. CMS classifies 99427 as an add-on code: it must be billed with a primary procedure and is paid within that procedure’s global period.
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 Arkansas compares for 99427
Across 109 of 109 payment localities, the office rate for 99427 runs from $49.25 in Arkansas to $68.64 in San Benito County, CA. Arkansas pays $49.25. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arkansas · this page$49.25
- Los Angeles, CA · California$59.78+$10.53
- Washington, DC area · District of Columbia$60.69+$11.44
- Miami, FL · Florida$57.84+$8.59
- Chicago, IL · Illinois$56.58+$7.33
- Manhattan, NY · New York$61.26+$12.01
- Alaska · Alaska$67.08+$17.83
Other areas in Arkansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $49.79 | $29.92 |
| ArizonaArizona | $52.98 | $30.97 |
| Bakersfield, CACalifornia | $56.66 | $31.77 |
| Chico, CACalifornia | $56.50 | $31.60 |
| El Centro, CACalifornia | $56.50 | $31.61 |
| Fresno, CACalifornia | $56.50 | $31.60 |
| Hanford, CACalifornia | $56.50 | $31.60 |
| Madera, CACalifornia | $56.50 | $31.60 |
| Merced, CACalifornia | $56.50 | $31.60 |
| Modesto, CACalifornia | $56.50 | $31.60 |
| Napa, CACalifornia | $63.92 | $33.98 |
| Oxnard, CACalifornia | $59.37 | $32.53 |
| Redding, CACalifornia | $56.50 | $31.60 |
| Rest of CaliforniaCalifornia | $56.50 | $31.60 |
| Riverside, CACalifornia | $57.05 | $32.16 |
| Sacramento, CACalifornia | $58.87 | $32.46 |
| Salinas, CACalifornia | $58.64 | $32.31 |
| San Diego, CACalifornia | $59.69 | $32.52 |
| Marin County, CACalifornia | $67.24 | $35.21 |
| San Francisco, CACalifornia | $67.18 | $35.15 |
| San Benito County, CACalifornia | $68.64 | $35.89 |
| Santa Clara County, CACalifornia | $68.41 | $35.66 |
| San Luis Obispo, CACalifornia | $57.73 | $31.86 |
| Santa Cruz, CACalifornia | $60.01 | $32.41 |
| Santa Maria, CACalifornia | $58.77 | $32.28 |
| Santa Rosa, CACalifornia | $60.60 | $32.70 |
| Stockton, CACalifornia | $56.50 | $31.60 |
| Vallejo, CACalifornia | $63.83 | $33.90 |
| Visalia, CACalifornia | $56.50 | $31.60 |
| Yuba City, CACalifornia | $56.50 | $31.60 |
| ColoradoColorado | $55.87 | $31.70 |
| ConnecticutConnecticut | $57.15 | $32.68 |
| DelawareDelaware | $53.71 | $31.27 |
| Fort Lauderdale, FLFlorida | $55.83 | $32.82 |
| Rest of FloridaFlorida | $53.69 | $31.97 |
| Atlanta, GAGeorgia | $54.98 | $31.90 |
| Rest of GeorgiaGeorgia | $51.33 | $31.07 |
| Hawaii, Guam, HIHawaii | $57.34 | $31.52 |
| IowaIowa | $50.66 | $29.88 |
| IdahoIdaho | $50.93 | $30.04 |
| East St. Louis, ILIllinois | $53.50 | $32.61 |
| Rest of IllinoisIllinois | $52.55 | $31.81 |
| Suburban Chicago, ILIllinois | $56.34 | $33.01 |
| IndianaIndiana | $51.15 | $30.10 |
| KansasKansas | $50.52 | $29.99 |
| KentuckyKentucky | $50.78 | $30.59 |
| New Orleans, LALouisiana | $52.64 | $31.27 |
| Rest of LouisianaLouisiana | $50.74 | $30.64 |
| Metropolitan Boston, MAMassachusetts | $60.47 | $33.35 |
| Rest of MassachusettsMassachusetts | $55.67 | $31.76 |
| Baltimore area, MDMaryland | $56.98 | $32.61 |
| Rest of MarylandMaryland | $54.55 | $31.57 |
| Rest of MaineMaine | $51.18 | $30.28 |
| Southern Maine, MEMaine | $53.23 | $30.73 |
| Detroit, MIMichigan | $54.25 | $32.33 |
| Rest of MichiganMichigan | $51.83 | $31.09 |
| MinnesotaMinnesota | $53.77 | $30.40 |
| Metropolitan Kansas City, MOMissouri | $52.32 | $30.99 |
| Metropolitan St. Louis, MOMissouri | $52.73 | $31.11 |
| Rest of MissouriMissouri | $50.10 | $30.52 |
| MississippiMississippi | $49.68 | $30.13 |
| MontanaMontana | $54.11 | $31.39 |
| North CarolinaNorth Carolina | $51.58 | $30.39 |
| North DakotaNorth Dakota | $53.12 | $30.40 |
| NebraskaNebraska | $50.86 | $29.90 |
| New HampshireNew Hampshire | $55.08 | $31.43 |
| Northern New JerseyNew Jersey | $60.31 | $33.97 |
| Rest of New JerseyNew Jersey | $57.86 | $33.06 |
| New MexicoNew Mexico | $52.06 | $31.23 |
| NevadaNevada | $53.86 | $31.12 |
| NYC suburbs and Long Island, NYNew York | $62.49 | $35.48 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $58.26 | $33.39 |
| Queens, NYNew York | $61.59 | $34.75 |
| Rest of New YorkNew York | $52.18 | $30.60 |
| OhioOhio | $51.62 | $30.89 |
| OklahomaOklahoma | $50.66 | $30.38 |
| Portland, OROregon | $57.25 | $32.02 |
| Rest of OregonOregon | $53.50 | $30.88 |
| Metropolitan Philadelphia, PAPennsylvania | $56.04 | $32.39 |
| Rest of PennsylvaniaPennsylvania | $51.66 | $30.81 |
| Puerto RicoPuerto Rico | $54.40 | $31.44 |
| Rhode IslandRhode Island | $55.33 | $31.87 |
| South CarolinaSouth Carolina | $51.68 | $30.69 |
| South DakotaSouth Dakota | $53.00 | $30.29 |
| TennesseeTennessee | $50.72 | $30.08 |
| Austin, TXTexas | $55.63 | $31.60 |
| Beaumont, TXTexas | $51.41 | $30.74 |
| Brazoria, TXTexas | $53.67 | $31.17 |
| Dallas, TXTexas | $53.97 | $31.35 |
| Fort Worth, TXTexas | $53.71 | $31.31 |
| Galveston, TXTexas | $53.81 | $31.26 |
| Houston, TXTexas | $54.73 | $32.17 |
| Rest of TexasTexas | $52.48 | $30.93 |
| UtahUtah | $52.22 | $30.87 |
| VirginiaVirginia | $53.13 | $30.80 |
| Virgin Islands, VIUnited States Virgin Islands | $54.40 | $31.44 |
| VermontVermont | $53.00 | $30.51 |
| Rest of WashingtonWashington | $55.54 | $31.62 |
| King County, WAWashington | $61.51 | $33.64 |
| WisconsinWisconsin | $51.75 | $29.99 |
| West VirginiaWest Virginia | $51.07 | $31.33 |
| WyomingWyoming | $53.68 | $30.96 |
99427 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.
$49.25
$67.08
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 | $67.08 | 1 |
| AL | $49.79 | 1 |
| AR | $49.25 | 1 |
| AZ | $52.98 | 1 |
| CA | $56.50–$68.64 | 29 |
| CO | $55.87 | 1 |
| CT | $57.15 | 1 |
| DC | $60.69 | 1 |
| DE | $53.71 | 1 |
| FL | $53.69–$57.84 | 3 |
| GA | $51.33–$54.98 | 2 |
| GU | $57.34 | 1 |
| HI | $57.34 | 1 |
| IA | $50.66 | 1 |
| ID | $50.93 | 1 |
| IL | $52.55–$56.58 | 4 |
| IN | $51.15 | 1 |
| KS | $50.52 | 1 |
| KY | $50.78 | 1 |
| LA | $50.74–$52.64 | 2 |
| MA | $55.67–$60.47 | 2 |
| MD | $54.55–$60.69 | 3 |
| ME | $51.18–$53.23 | 2 |
| MI | $51.83–$54.25 | 2 |
| MN | $53.77 | 1 |
| MO | $50.10–$52.73 | 3 |
| MS | $49.68 | 1 |
| MT | $54.11 | 1 |
| NC | $51.58 | 1 |
| ND | $53.12 | 1 |
| NE | $50.86 | 1 |
| NH | $55.08 | 1 |
| NJ | $57.86–$60.31 | 2 |
| NM | $52.06 | 1 |
| NV | $53.86 | 1 |
| NY | $52.18–$62.49 | 5 |
| OH | $51.62 | 1 |
| OK | $50.66 | 1 |
| OR | $53.50–$57.25 | 2 |
| PA | $51.66–$56.04 | 2 |
| PR | $54.40 | 1 |
| RI | $55.33 | 1 |
| SC | $51.68 | 1 |
| SD | $53.00 | 1 |
| TN | $50.72 | 1 |
| TX | $51.41–$55.63 | 8 |
| UT | $52.22 | 1 |
| VA | $53.13–$60.69 | 2 |
| VI | $54.40 | 1 |
| VT | $53.00 | 1 |
| WA | $55.54–$61.51 | 2 |
| WI | $51.75 | 1 |
| WV | $51.07 | 1 |
| WY | $53.68 | 1 |
How the 99427 rate is calculated
Each of 99427’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 · 99427
RVUs × geographic indexes × conversion factor
Work0.71
0.71 RVUs× 1.000 GPCI
Practice expense0.86
0.86 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.6200
Conversion factor
$33.4009
Medicare rate
$54.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arkansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,108
- Code
- 99427
- Physician work
- 0.71
- Practice expense
- 0.86
- Malpractice
- 0.05
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.71 | × 1.000 | 0.7100 |
| Practice expense | 0.86 | × 0.859 | 0.7387 |
| Malpractice | 0.05 | × 0.515 | 0.0258 |
| Total RVUs | 1.4745 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Arkansas$49.25
Office: (0.71 × 1 + 0.86 × 0.859 + 0.05 × 0.515) × $33.4009 = $49.25
Facility: (0.71 × 1 + 0.18 × 0.859 + 0.05 × 0.515) × $33.4009 = $29.74
Payment rules and modifiers for 99427
The CMS indicators that decide how 99427 is paid alongside other services.
CMS payment indicators · 99427
Principal care management, additional clinical staff time
| 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 | 0 | Physician service: no professional/technical split. |
How 99427 has changed in Arkansas
99427 · Office / nonfacility
$49.25
Effective 2026-10-01
The base rate is $3.08 higher than on 2025-10-01, moving from $46.17 to $49.25 (6.7%).
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
$46.17changed to$49.25
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.81 changed to 0.86
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.860 changed to 0.859
- Malpractice GPCI 0.518 changed to 0.515
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$43.39changed to$46.17
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.66 changed to 0.81
- Malpractice RVU 0.05 changed to 0.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$42.68changed to$43.39
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$43.27changed to$42.68
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.63 changed to 0.66
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 0.853 changed to 0.860
- Malpractice GPCI 0.492 changed to 0.518
January 1, 2023
RVU23A
$44.13changed to$43.27
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.64 changed to 0.63
- Malpractice RVU 0.05 changed to 0.06
- Practice expense GPCI 0.847 changed to 0.853
- Malpractice GPCI 0.465 changed to 0.492
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
No ratechanged to$44.13
Held through RVU22B, RVU22C, RVU22D.
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, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $49.25 | $29.74 | RVU26D |
| 2026-07-01 | $49.25 | $29.74 | RVU26C |
| 2026-04-01 | $49.25 | $29.74 | RVU26B |
| 2026-01-01 | $49.25 | $29.74 | RVU26A |
| 2025-10-01 | $46.17 | $32.26 | RVU25D |
| 2025-07-01 | $46.17 | $32.26 | RVU25C |
| 2025-04-01 | $46.17 | $32.26 | RVU25B |
| 2025-01-01 | $46.17 | $32.26 | RVU25A |
| 2024-10-01 | $43.39 | $32.23 | RVU24D |
| 2024-07-01 | $43.39 | $32.23 | RVU24C |
| 2024-04-01 | $43.39 | $32.23 | RVU24B |
| 2024-03-09 | $43.39 | $32.23 | RVU24AR |
| 2024-01-01 | $42.68 | $31.70 | RVU24A |
| 2023-10-01 | $43.27 | $32.58 | RVU23D |
| 2023-07-01 | $43.27 | $32.58 | RVU23C |
| 2023-04-01 | $43.27 | $32.58 | RVU23B |
| 2023-01-01 | $43.27 | $32.58 | RVU23A |
| 2022-10-01 | $44.13 | $33.29 | RVU22D |
| 2022-07-01 | $44.13 | $33.29 | RVU22C |
| 2022-04-01 | $44.13 | $33.29 | RVU22B |
| 2022-01-01 | $44.13 | $33.29 | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | 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 Arkansas rate applies
Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.
- Acorn
- Adona
- Alexander
- Alicia
- Alix
- Alleene
- Allport
- Alma
99427 billing questions
What code must be reported with 99427?
Report 99427 with 99426, which represents the initial clinical staff principal care management interval. 99427 accounts for additional staff time.
How is 99427 different from 99426?
99426 reports the initial 30 minutes of clinical staff principal care management. 99427 reports each additional 30 minutes in the same calendar month.
How does 99427 differ from 99425?
Both are additional principal care management codes, but 99427 is for clinical staff time and 99425 is for physician or other qualified health care professional time.
What documentation supports an additional unit?
Document the serious chronic condition, its care plan, the clinical staff activities performed, and the time supporting the additional interval during the calendar month.
Can 99427 be reported by itself?
No. It is an add-on code and must be billed with its primary code, 99426.
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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