CPT code 99448: Interprofessional consultation, 21–30 minutes2026 Medicare rate & RVUs in Merced, CA

A consulting physician reviews a patient’s clinical information and gives the treating clinician verbal and written guidance after 21–30 minutes of work.

CMS RVU26DEffective Oct 1, 2026One payment locality9.2K Medicare services in 2024

In Merced, CA, Medicare pays $57.78 for 99448 in the office and $47.89 when it’s performed in a hospital or facility.

$57.78Office (non-facility)
$47.89Hospital or facility
+1.8%vs the national office rate ($56.78)

Check a contract rate as a % of Medicare · 99448 nationwide

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

We’ll open 99448 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Merced, CA
  2. What 99448 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99448 covers

A consulting physician uses this service to assess a patient’s clinical question by reviewing records, test results, or other relevant information and discussing recommendations with the treating or requesting clinician. The consultation is between clinicians rather than a direct patient visit. Common situations include a primary care clinician seeking specialist input on a complex rash from a record review or asking a cardiologist to advise on findings in the patient’s chart.

Report 99448 when the consultant’s qualifying work totals 21–30 minutes and includes both verbal communication and a written report to the treating or requesting clinician. Documentation should identify the clinical question, information reviewed, time spent, recommendations, and how the verbal and written responses were provided. The CMS physician fee schedule assigns work and practice-expense values to this service. The documented time distinguishes this code from the shorter and longer consultation levels.

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 Merced, CA compares for 99448

Across 109 of 109 payment localities, the office rate for 99448 runs from $52.69 in Arkansas to $74.18 in Alaska. Merced, CA pays $57.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

99448 in Merced, CA vs other payment areas
  1. Merced, CA · this page$57.78
  2. Bakersfield, CA · California$58.07+$0.29
  3. Chico, CA · California$57.78
  4. El Centro, CA · California$57.79+$0.01
  5. Fresno, CA · California$57.78
  6. Hanford, CA · California$57.78
  7. Los Angeles, CA · California$60.63+$2.85

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

99448 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$57.78$47.89
Modesto, CACalifornia$57.78$47.89
Napa, CACalifornia$63.46$51.57
Oxnard, CACalifornia$60.03$49.37
Redding, CACalifornia$57.78$47.89
Rest of CaliforniaCalifornia$57.78$47.89
Riverside, CACalifornia$58.77$48.88
Sacramento, CACalifornia$59.70$49.21

99448 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.

$52.69

$74.18

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99448 office rate range by state
State / territoryOffice rate rangeLocalities
AK$74.181
AL$53.141
AR$52.691
AZ$55.771
CA$57.78–$67.5129
CO$57.741
CT$59.551
DC$62.341
DE$56.431
FL$57.47–$62.143
GA$55.34–$57.792
GU$58.081
HI$58.081
IA$53.381
ID$53.701
IL$56.85–$61.014
IN$53.871
KS$53.491
KY$54.451
LA$54.50–$56.092
MA$57.72–$61.522
MD$57.11–$62.343
ME$54.15–$55.502
MI$55.54–$58.192
MN$55.211
MO$54.12–$55.893
MS$53.401
MT$56.781
NC$54.441
ND$55.001
NE$53.471
NH$57.171
NJ$60.20–$62.192
NM$55.831
NV$56.301
NY$54.95–$65.145
OH$55.181
OK$54.111
OR$55.81–$58.652
PA$55.08–$58.762
PR$56.941
RI$57.741
SC$54.911
SD$54.791
TN$53.691
TX$54.88–$58.068
UT$55.351
VA$55.58–$62.342
VI$56.941
VT$55.111
WA$57.51–$62.232
WI$53.921
WV$55.631
WY$56.001

See 99448 in every payment locality

How the 99448 rate is calculated

Each of 99448’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 · 99448

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.05

1.05 RVUs× 1.000 GPCI

Practice expense0.56

0.56 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

1.7000

Conversion factor

$33.4009

Medicare rate

$56.78

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Merced, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,115

Code
99448
Physician work
1.05
Practice expense
0.56
Malpractice
0.09

GPCI2026.csv

15

Locality
Merced, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 99448 in Merced, CA
ComponentRVULocality factorAdjusted
Physician work1.05× 1.0171.0678
Practice expense0.56× 1.0960.6138
Malpractice0.09× 0.5360.0482
Total RVUs1.7299
Conversion factor× 33.4009

Office rate, Merced, CA$57.78

Office: (1.05 × 1.017 + 0.56 × 1.096 + 0.09 × 0.536) × $33.4009 = $57.78

Facility: (1.05 × 1.017 + 0.29 × 1.096 + 0.09 × 0.536) × $33.4009 = $47.89

Open 99448 in the RVU calculator

Payment rules and modifiers for 99448

99448 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 · 99448

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$56.78

Non-facility (office)
$56.78
Facility
$47.76

Higher because the practice carries its own overhead.

How 99448 has changed in Merced, CA

99448 · Office / nonfacility

$57.78

Effective 2026-10-01

The base rate is $5.63 higher than on 2025-10-01, moving from $52.15 to $57.78 (10.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $52.15changed to$57.78

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.46 changed to 0.56
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $53.86changed to$52.15

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $52.98changed to$53.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $54.74changed to$52.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.45 changed to 0.46
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $55.76changed to$54.74

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $54.37changed to$55.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.40 changed to 0.45

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $56.13changed to$54.37

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $55.68changed to$56.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.41 changed to 0.40
    • Malpractice RVU 0.06 changed to 0.09
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$55.68

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2014

    RVU14A

    No ratechanged toNo rate

    Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$57.78$47.89RVU26D
2026-07-01$57.78$47.89RVU26C
2026-04-01$57.78$47.89RVU26B
2026-01-01$57.78$47.89RVU26A
2025-10-01$52.15$52.15RVU25D
2025-07-01$52.15$52.15RVU25C
2025-04-01$52.15$52.15RVU25B
2025-01-01$52.15$52.15RVU25A
2024-10-01$53.86$53.86RVU24D
2024-07-01$53.86$53.86RVU24C
2024-04-01$53.86$53.86RVU24B
2024-03-09$53.86$53.86RVU24AR
2024-01-01$52.98$52.98RVU24A
2023-10-01$54.74$54.74RVU23D
2023-07-01$54.74$54.74RVU23C
2023-04-01$54.74$54.74RVU23B
2023-01-01$54.74$54.74RVU23A
2022-10-01$55.76$55.76RVU22D
2022-07-01$55.76$55.76RVU22C
2022-04-01$55.76$55.76RVU22B
2022-01-01$55.76$55.76RVU22A
2021-10-01$54.37$54.37RVU21D
2021-07-01$54.37$54.37RVU21C
2021-04-01$54.37$54.37RVU21B
2021-01-01$54.37$54.37RVU21A
2020-10-01$56.13$56.13RVU20D
2020-07-01$56.13$56.13RVU20C
2020-04-01$56.13$56.13RVU20B
2020-01-01$56.13$56.13RVU20A
2019-10-01$55.68$55.68RVU19D
2019-07-01$55.68$55.68RVU19C
2019-04-01$55.68$55.68RVU19B
2019-01-01$55.68$55.68RVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99448 for an earlier date of service

Where the Merced, CA rate applies

Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Merced
  • Atwater
  • Ballico
  • Bear Creek
  • Cressey
  • Delhi
  • Dos Palos
  • Dos Palos Y

Browse all communities in California

99448 billing questions

When should 99448 be selected instead of 99447 or 99449?

Select 99448 when the consultant’s qualifying work totals 21–30 minutes. The neighboring levels cover shorter or longer time intervals.

Does the service include communication with the treating clinician?

Yes. This level includes verbal communication and a written report to the treating or requesting clinician; document both.

Can 99448 be used for a direct visit with the patient?

It describes an interprofessional consultation in which a consulting physician provides guidance to the treating or requesting clinician, rather than a direct patient visit.

What should the record support?

Document the clinical question, records or results reviewed, total time, recommendations, and the verbal and written communication with the requesting clinician.

How does 99448 differ from 99451?

99448 is the 21–30-minute level that includes verbal and written communication. 99451 is a separate consultant-service option with a written report and a different time threshold.

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
RVUs for 99448PPRRVU2026_Oct_nonQPP.csv, line 13,115 (RVU26D)
Geographic factors for Merced, CAGPCI2026.csv, line 15 (RVU26D)

Open CMS sourceHow we calculate rates

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