CPT code 99449: Interprofessional consult, 31 minutes or more2026 Medicare rate & RVUs in West Virginia
Reports a consultant physician’s remote review, discussion, and written recommendations when requested by a treating clinician and the service takes at least 31 minutes.
In West Virginia, Medicare pays $74.56 for 99449 in the office and $63.53 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99449 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 99449 covers
99449 captures a consultant physician’s substantial remote review and management input for a patient whose treating clinician requests specialty advice. The consultant reviews relevant records or test results, discusses findings and recommendations with the treating or requesting physician or other qualified health care professional, and sends a written report. A typical case is a primary care clinician seeking cardiology, neurology, infectious disease, or endocrinology guidance without arranging a face-to-face visit with the consultant.
Select 99449 when the consultant’s qualifying work totals at least 31 minutes; codes 99446–99448 cover shorter time bands. Document the request and clinical question, records reviewed, consult communication, recommendations and written report, and the consultant time supporting the threshold. The requesting clinician’s coordination work is distinct and may be reported with 99452 when its requirements are met. The CMS fee schedule values 99449 through work, practice-expense, and malpractice RVUs.
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 West Virginia compares for 99449
Across 109 of 109 payment localities, the office rate for 99449 runs from $70.63 in Arkansas to $99.39 in Alaska. West Virginia pays $74.56. The RVUs are the same everywhere; the geographic indexes change the dollars.
- West Virginia · this page$74.56
- Los Angeles, CA · California$81.37+$6.81
- Washington, DC area · District of Columbia$83.65+$9.09
- Miami, FL · Florida$83.32+$8.76
- Chicago, IL · Illinois$81.80+$7.24
- Manhattan, NY · New York$85.61+$11.05
- Alaska · Alaska$99.39+$24.83
Other areas in West Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $71.24 | $60.14 |
| ArkansasArkansas | $70.63 | $59.73 |
| ArizonaArizona | $74.79 | $62.49 |
| Bakersfield, CACalifornia | $77.91 | $64.00 |
| Chico, CACalifornia | $77.53 | $63.62 |
| El Centro, CACalifornia | $77.55 | $63.64 |
| Fresno, CACalifornia | $77.53 | $63.62 |
| Hanford, CACalifornia | $77.53 | $63.62 |
| Madera, CACalifornia | $77.53 | $63.62 |
| Merced, CACalifornia | $77.53 | $63.62 |
| Modesto, CACalifornia | $77.53 | $63.62 |
| Napa, CACalifornia | $85.20 | $68.47 |
| Oxnard, CACalifornia | $80.57 | $65.57 |
| Redding, CACalifornia | $77.53 | $63.62 |
| Rest of CaliforniaCalifornia | $77.53 | $63.62 |
| Riverside, CACalifornia | $78.84 | $64.93 |
| Sacramento, CACalifornia | $80.12 | $65.35 |
| Salinas, CACalifornia | $79.78 | $65.07 |
| San Diego, CACalifornia | $80.70 | $65.52 |
| Marin County, CACalifornia | $88.84 | $70.94 |
| San Francisco, CACalifornia | $88.70 | $70.80 |
| San Benito County, CACalifornia | $90.66 | $72.36 |
| Santa Clara County, CACalifornia | $90.10 | $71.80 |
| San Luis Obispo, CACalifornia | $78.62 | $64.16 |
| Santa Cruz, CACalifornia | $80.73 | $65.31 |
| Santa Maria, CACalifornia | $79.82 | $65.02 |
| Santa Rosa, CACalifornia | $81.48 | $65.90 |
| Stockton, CACalifornia | $77.53 | $63.62 |
| Vallejo, CACalifornia | $85.00 | $68.28 |
| Visalia, CACalifornia | $77.53 | $63.62 |
| Yuba City, CACalifornia | $77.53 | $63.62 |
| ColoradoColorado | $77.46 | $63.96 |
| ConnecticutConnecticut | $79.89 | $66.22 |
| DelawareDelaware | $75.68 | $63.14 |
| Fort Lauderdale, FLFlorida | $79.72 | $66.87 |
| Rest of FloridaFlorida | $77.05 | $64.92 |
| Atlanta, GAGeorgia | $77.51 | $64.61 |
| Rest of GeorgiaGeorgia | $74.18 | $62.86 |
| Hawaii, Guam, HIHawaii | $77.94 | $63.51 |
| IowaIowa | $71.58 | $59.97 |
| IdahoIdaho | $72.01 | $60.33 |
| East St. Louis, ILIllinois | $78.19 | $66.51 |
| Rest of IllinoisIllinois | $76.20 | $64.61 |
| Suburban Chicago, ILIllinois | $80.26 | $67.23 |
| IndianaIndiana | $72.24 | $60.48 |
| KansasKansas | $71.73 | $60.26 |
| KentuckyKentucky | $73.00 | $61.71 |
| New Orleans, LALouisiana | $75.20 | $63.26 |
| Rest of LouisianaLouisiana | $73.07 | $61.83 |
| Metropolitan Boston, MAMassachusetts | $82.56 | $67.40 |
| Rest of MassachusettsMassachusetts | $77.43 | $64.07 |
| Baltimore area, MDMaryland | $79.71 | $66.09 |
| Rest of MarylandMaryland | $76.60 | $63.75 |
| Rest of MaineMaine | $72.61 | $60.93 |
| Southern Maine, MEMaine | $74.45 | $61.87 |
| Detroit, MIMichigan | $78.02 | $65.77 |
| Rest of MichiganMichigan | $74.46 | $62.87 |
| MinnesotaMinnesota | $74.07 | $61.01 |
| Metropolitan Kansas City, MOMissouri | $74.51 | $62.60 |
| Metropolitan St. Louis, MOMissouri | $74.94 | $62.86 |
| Rest of MissouriMissouri | $72.55 | $61.61 |
| MississippiMississippi | $71.58 | $60.65 |
| MontanaMontana | $76.15 | $63.45 |
| North CarolinaNorth Carolina | $73.01 | $61.16 |
| North DakotaNorth Dakota | $73.77 | $61.08 |
| NebraskaNebraska | $71.71 | $59.99 |
| New HampshireNew Hampshire | $76.69 | $63.48 |
| Northern New JerseyNew Jersey | $83.43 | $68.71 |
| Rest of New JerseyNew Jersey | $80.75 | $66.89 |
| New MexicoNew Mexico | $74.85 | $63.21 |
| NevadaNevada | $75.51 | $62.81 |
| NYC suburbs and Long Island, NYNew York | $87.38 | $72.29 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $81.51 | $67.61 |
| Queens, NYNew York | $85.54 | $70.54 |
| Rest of New YorkNew York | $73.69 | $61.64 |
| OhioOhio | $73.98 | $62.39 |
| OklahomaOklahoma | $72.54 | $61.21 |
| Portland, OROregon | $78.69 | $64.59 |
| Rest of OregonOregon | $74.86 | $62.22 |
| Metropolitan Philadelphia, PAPennsylvania | $78.81 | $65.60 |
| Rest of PennsylvaniaPennsylvania | $73.85 | $62.20 |
| Puerto RicoPuerto Rico | $76.37 | $63.54 |
| Rhode IslandRhode Island | $77.45 | $64.34 |
| South CarolinaSouth Carolina | $73.62 | $61.90 |
| South DakotaSouth Dakota | $73.49 | $60.80 |
| TennesseeTennessee | $71.99 | $60.45 |
| Austin, TXTexas | $77.26 | $63.83 |
| Beaumont, TXTexas | $73.58 | $62.03 |
| Brazoria, TXTexas | $75.42 | $62.84 |
| Dallas, TXTexas | $75.90 | $63.26 |
| Fort Worth, TXTexas | $75.70 | $63.19 |
| Galveston, TXTexas | $75.66 | $63.06 |
| Houston, TXTexas | $77.86 | $65.25 |
| Rest of TexasTexas | $74.47 | $62.43 |
| UtahUtah | $74.22 | $62.29 |
| VirginiaVirginia | $74.54 | $62.07 |
| Virgin Islands, VIUnited States Virgin Islands | $76.37 | $63.54 |
| VermontVermont | $73.92 | $61.35 |
| Rest of WashingtonWashington | $77.15 | $63.78 |
| King County, WAWashington | $83.52 | $67.95 |
| WisconsinWisconsin | $72.31 | $60.16 |
| WyomingWyoming | $75.11 | $62.42 |
99449 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.
$70.63
$99.39
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 | $99.39 | 1 |
| AL | $71.24 | 1 |
| AR | $70.63 | 1 |
| AZ | $74.79 | 1 |
| CA | $77.53–$90.66 | 29 |
| CO | $77.46 | 1 |
| CT | $79.89 | 1 |
| DC | $83.65 | 1 |
| DE | $75.68 | 1 |
| FL | $77.05–$83.32 | 3 |
| GA | $74.18–$77.51 | 2 |
| GU | $77.94 | 1 |
| HI | $77.94 | 1 |
| IA | $71.58 | 1 |
| ID | $72.01 | 1 |
| IL | $76.20–$81.80 | 4 |
| IN | $72.24 | 1 |
| KS | $71.73 | 1 |
| KY | $73.00 | 1 |
| LA | $73.07–$75.20 | 2 |
| MA | $77.43–$82.56 | 2 |
| MD | $76.60–$83.65 | 3 |
| ME | $72.61–$74.45 | 2 |
| MI | $74.46–$78.02 | 2 |
| MN | $74.07 | 1 |
| MO | $72.55–$74.94 | 3 |
| MS | $71.58 | 1 |
| MT | $76.15 | 1 |
| NC | $73.01 | 1 |
| ND | $73.77 | 1 |
| NE | $71.71 | 1 |
| NH | $76.69 | 1 |
| NJ | $80.75–$83.43 | 2 |
| NM | $74.85 | 1 |
| NV | $75.51 | 1 |
| NY | $73.69–$87.38 | 5 |
| OH | $73.98 | 1 |
| OK | $72.54 | 1 |
| OR | $74.86–$78.69 | 2 |
| PA | $73.85–$78.81 | 2 |
| PR | $76.37 | 1 |
| RI | $77.45 | 1 |
| SC | $73.62 | 1 |
| SD | $73.49 | 1 |
| TN | $71.99 | 1 |
| TX | $73.58–$77.86 | 8 |
| UT | $74.22 | 1 |
| VA | $74.54–$83.65 | 2 |
| VI | $76.37 | 1 |
| VT | $73.92 | 1 |
| WA | $77.15–$83.52 | 2 |
| WI | $72.31 | 1 |
| WV | $74.56 | 1 |
| WY | $75.11 | 1 |
How the 99449 rate is calculated
Each of 99449’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 · 99449
RVUs × geographic indexes × conversion factor
Work1.40
1.40 RVUs× 1.000 GPCI
Practice expense0.76
0.76 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
2.2800
Conversion factor
$33.4009
Medicare rate
$76.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact West Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,116
- Code
- 99449
- Physician work
- 1.40
- Practice expense
- 0.76
- Malpractice
- 0.12
GPCI2026.csv
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.40 | × 1.000 | 1.4000 |
| Practice expense | 0.76 | × 0.869 | 0.6604 |
| Malpractice | 0.12 | × 1.431 | 0.1717 |
| Total RVUs | 2.2322 | ||
| Conversion factor | × 33.4009 | ||
Office rate, West Virginia$74.56
Office: (1.4 × 1 + 0.76 × 0.869 + 0.12 × 1.431) × $33.4009 = $74.56
Facility: (1.4 × 1 + 0.38 × 0.869 + 0.12 × 1.431) × $33.4009 = $63.53
Payment rules and modifiers for 99449
99449 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 · 99449
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$76.15
- Non-facility (office)
- $76.15
- Facility
- $63.46
Higher because the practice carries its own overhead.
How 99449 has changed in West Virginia
99449 · Office / nonfacility
$74.56
Effective 2026-10-01
The base rate is $6.53 higher than on 2025-10-01, moving from $68.03 to $74.56 (9.6%).
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
$68.03changed to$74.56
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.63 changed to 0.76
- Practice expense GPCI 0.862 changed to 0.869
- Malpractice GPCI 1.333 changed to 1.431
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$69.27changed to$68.03
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.62 changed to 0.63
- Malpractice RVU 0.11 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$68.14changed to$69.27
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$69.94changed to$68.14
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.61 changed to 0.62
- Practice expense GPCI 0.860 changed to 0.862
- Malpractice GPCI 1.266 changed to 1.333
January 1, 2023
RVU23A
$71.42changed to$69.94
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.62 changed to 0.61
- Practice expense GPCI 0.858 changed to 0.860
- Malpractice GPCI 1.198 changed to 1.266
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$71.11changed to$71.42
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.59 changed to 0.62
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$72.18changed to$71.11
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.54 changed to 0.59
- Practice expense GPCI 0.857 changed to 0.858
- Malpractice GPCI 1.247 changed to 1.198
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$70.87changed to$72.18
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.08 changed to 0.11
- Malpractice GPCI 1.296 changed to 1.247
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$70.87
Held through RVU19B, RVU19C, RVU19D.
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.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $74.56 | $63.53 | RVU26D |
| 2026-07-01 | $74.56 | $63.53 | RVU26C |
| 2026-04-01 | $74.56 | $63.53 | RVU26B |
| 2026-01-01 | $74.56 | $63.53 | RVU26A |
| 2025-10-01 | $68.03 | $68.03 | RVU25D |
| 2025-07-01 | $68.03 | $68.03 | RVU25C |
| 2025-04-01 | $68.03 | $68.03 | RVU25B |
| 2025-01-01 | $68.03 | $68.03 | RVU25A |
| 2024-10-01 | $69.27 | $69.27 | RVU24D |
| 2024-07-01 | $69.27 | $69.27 | RVU24C |
| 2024-04-01 | $69.27 | $69.27 | RVU24B |
| 2024-03-09 | $69.27 | $69.27 | RVU24AR |
| 2024-01-01 | $68.14 | $68.14 | RVU24A |
| 2023-10-01 | $69.94 | $69.94 | RVU23D |
| 2023-07-01 | $69.94 | $69.94 | RVU23C |
| 2023-04-01 | $69.94 | $69.94 | RVU23B |
| 2023-01-01 | $69.94 | $69.94 | RVU23A |
| 2022-10-01 | $71.42 | $71.42 | RVU22D |
| 2022-07-01 | $71.42 | $71.42 | RVU22C |
| 2022-04-01 | $71.42 | $71.42 | RVU22B |
| 2022-01-01 | $71.42 | $71.42 | RVU22A |
| 2021-10-01 | $71.11 | $71.11 | RVU21D |
| 2021-07-01 | $71.11 | $71.11 | RVU21C |
| 2021-04-01 | $71.11 | $71.11 | RVU21B |
| 2021-01-01 | $71.11 | $71.11 | RVU21A |
| 2020-10-01 | $72.18 | $72.18 | RVU20D |
| 2020-07-01 | $72.18 | $72.18 | RVU20C |
| 2020-04-01 | $72.18 | $72.18 | RVU20B |
| 2020-01-01 | $72.18 | $72.18 | RVU20A |
| 2019-10-01 | $70.87 | $70.87 | RVU19D |
| 2019-07-01 | $70.87 | $70.87 | RVU19C |
| 2019-04-01 | $70.87 | $70.87 | RVU19B |
| 2019-01-01 | $70.87 | $70.87 | RVU19A |
| 2018-10-01 | Separate payment rules apply | Separate payment rules apply | RVU18D |
| 2018-07-01 | Separate payment rules apply | Separate payment rules apply | RVU18C |
| 2018-04-01 | Separate payment rules apply | Separate payment rules apply | RVU18B |
| 2018-01-01 | Separate payment rules apply | Separate payment rules apply | RVU18AR1 |
| 2017-10-01 | Separate payment rules apply | Separate payment rules apply | RVU17D |
| 2017-07-01 | Separate payment rules apply | Separate payment rules apply | RVU17C |
| 2017-04-01 | Separate payment rules apply | Separate payment rules apply | RVU17B |
| 2017-01-01 | Separate payment rules apply | Separate payment rules apply | RVU17A |
| 2016-10-01 | Separate payment rules apply | Separate payment rules apply | RVU16D |
| 2016-07-01 | Separate payment rules apply | Separate payment rules apply | RVU16C |
| 2016-04-01 | Separate payment rules apply | Separate payment rules apply | RVU16B |
| 2016-01-01 | Separate payment rules apply | Separate payment rules apply | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Separate payment rules apply | Separate payment rules apply | RVU14D |
| 2014-07-01 | Separate payment rules apply | Separate payment rules apply | RVU14C |
| 2014-04-01 | Separate payment rules apply | Separate payment rules apply | RVU14B |
| 2014-01-01 | Separate payment rules apply | Separate payment rules apply | 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 West Virginia rate applies
West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.
- Accoville
- Addison (Webster Springs)
- Adrian
- Albright
- Alderson
- Alum Creek
- Amherstdale
- Anawalt
99449 billing questions
When should 99449 be selected instead of 99448?
Use 99449 when the consultant’s qualifying service reaches at least 31 minutes. Code 99448 is the 21–30 minute band.
Does 99449 require both a discussion and a written report?
Yes. The service includes communication of the consultant’s advice to the treating or requesting clinician and a written report.
Can the requesting clinician’s work be reported separately?
The requesting clinician’s referral preparation and communication work is separate from the consultant’s service. Code 99452 may apply when its requirements are met.
What documentation supports 99449?
Document who requested the consultation, the clinical question, records reviewed, the communication and recommendations, the written report, and the consultant’s time.
Can 99449 represent an in-person specialist evaluation?
No. It represents remote interprofessional assessment and communication, not the consultant’s face-to-face evaluation of the patient.
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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