CPT code 99452: Referral coordination, requesting clinician, 30 minutes2026 Medicare rate & RVUs in Iowa

Reports 30 minutes of referral work by the treating clinician, including preparing records and coordinating an interprofessional consultation with another clinician.

CMS RVU26DEffective Oct 1, 2026One payment locality40.1K Medicare services in 2024

In Iowa, Medicare pays $35.05 for 99452 in the office and $29.54 when it’s performed in a hospital or facility.

$35.05Office (non-facility)
$29.54Hospital or facility
−5.4%vs the national office rate ($37.07)

Check a contract rate as a % of Medicare · 99452 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 99452 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 99452 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 99452 covers

99452 represents the treating or requesting physician’s or qualified health care professional’s work to arrange an interprofessional consultation. That work can include reviewing and preparing the patient’s records, sending the clinical question and relevant information to a consultant, and coordinating the referral. It is used when the clinicians communicate through telephone, internet, or the electronic health record rather than conducting a joint face-to-face visit. The requesting clinician reports their own referral work; the consultant’s assessment and response are a separate service.

Report 99452 when the requesting clinician’s documented work reaches 30 minutes. Record the consultation request, the records and clinical information provided, communication or coordination performed, and total time. CMS assigns the service work and practice-expense values, with different practice-expense inputs for office and facility settings. The related consultant-side codes are selected according to the consultant’s service and time, not the requesting clinician’s referral time.

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 Iowa compares for 99452

Across 109 of 109 payment localities, the office rate for 99452 runs from $34.57 in Arkansas to $48.80 in Alaska. Iowa pays $35.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

99452 in Iowa vs other payment areas
  1. Iowa · this page$35.05
  2. Los Angeles, CA · California$39.67+$4.62
  3. Washington, DC area · District of Columbia$40.67+$5.62
  4. Miami, FL · Florida$40.12+$5.07
  5. Chicago, IL · Illinois$39.46+$4.41
  6. Manhattan, NY · New York$41.50+$6.45
  7. Alaska · Alaska$48.80+$13.75

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

Every other payment area

99452 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$34.85$29.59
ArkansasArkansas$34.57$29.41
ArizonaArizona$36.46$30.64
Bakersfield, CACalifornia$38.02$31.43
Chico, CACalifornia$37.85$31.26
El Centro, CACalifornia$37.86$31.27
Fresno, CACalifornia$37.85$31.26
Hanford, CACalifornia$37.85$31.26

99452 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.

$34.57

$48.80

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

View every state and territory as a table
99452 office rate range by state
State / territoryOffice rate rangeLocalities
AK$48.801
AL$34.851
AR$34.571
AZ$36.461
CA$37.85–$44.1929
CO$37.761
CT$38.821
DC$40.671
DE$36.881
FL$37.39–$40.123
GA$36.10–$37.672
GU$38.021
HI$38.021
IA$35.051
ID$35.231
IL$36.97–$39.464
IN$35.341
KS$35.091
KY$35.601
LA$35.62–$36.592
MA$37.75–$40.182
MD$37.32–$40.673
ME$35.48–$36.352
MI$36.24–$37.802
MN$36.251
MO$35.37–$36.503
MS$34.971
MT$37.071
NC$35.671
ND$36.081
NE$35.111
NH$37.361
NJ$39.28–$40.592
NM$36.411
NV$36.811
NY$35.98–$42.285
OH$36.041
OK$35.421
OR$36.53–$38.362
PA$36.00–$38.312
PR$37.181
RI$37.741
SC$35.911
SD$35.971
TN$35.211
TX$35.87–$37.818
UT$36.181
VA$36.38–$40.672
VI$37.181
VT$36.131
WA$37.62–$40.672
WI$35.411
WV$36.221
WY$36.641

See 99452 in every payment locality

How the 99452 rate is calculated

Each of 99452’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 · 99452

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.70

0.70 RVUs× 1.000 GPCI

Practice expense0.36

0.36 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.1100

Conversion factor

$33.4009

Medicare rate

$37.07

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,119

Code
99452
Physician work
0.70
Practice expense
0.36
Malpractice
0.05

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 99452 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.70× 1.0000.7000
Practice expense0.36× 0.9150.3294
Malpractice0.05× 0.3970.0199
Total RVUs1.0492
Conversion factor× 33.4009

Office rate, Iowa$35.05

Office: (0.7 × 1 + 0.36 × 0.915 + 0.05 × 0.397) × $33.4009 = $35.05

Facility: (0.7 × 1 + 0.18 × 0.915 + 0.05 × 0.397) × $33.4009 = $29.54

Open 99452 in the RVU calculator

Payment rules and modifiers for 99452

99452 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 · 99452

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$37.07

Non-facility (office)
$37.07
Facility
$31.06

Higher because the practice carries its own overhead.

How 99452 has changed in Iowa

99452 · Office / nonfacility

$35.05

Effective 2026-10-01

The base rate is $2.96 higher than on 2025-10-01, moving from $32.09 to $35.05 (9.2%).

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

    $32.09changed to$35.05

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.30 changed to 0.36
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.12changed to$32.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.27 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $31.59changed to$32.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $31.72changed to$31.59

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.24 changed to 0.27
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $34.67changed to$31.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.30 changed to 0.24
    • Malpractice RVU 0.07 changed to 0.04
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $34.66changed to$34.67

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.05 changed to 0.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $35.52changed to$34.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.29 changed to 0.30
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $35.47changed to$35.52

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$35.47

    Held through RVU19B, RVU19C, RVU19D.

  10. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$35.05$29.54RVU26D
2026-07-01$35.05$29.54RVU26C
2026-04-01$35.05$29.54RVU26B
2026-01-01$35.05$29.54RVU26A
2025-10-01$32.09$32.09RVU25D
2025-07-01$32.09$32.09RVU25C
2025-04-01$32.09$32.09RVU25B
2025-01-01$32.09$32.09RVU25A
2024-10-01$32.12$32.12RVU24D
2024-07-01$32.12$32.12RVU24C
2024-04-01$32.12$32.12RVU24B
2024-03-09$32.12$32.12RVU24AR
2024-01-01$31.59$31.59RVU24A
2023-10-01$31.72$31.72RVU23D
2023-07-01$31.72$31.72RVU23C
2023-04-01$31.72$31.72RVU23B
2023-01-01$31.72$31.72RVU23A
2022-10-01$34.67$34.67RVU22D
2022-07-01$34.67$34.67RVU22C
2022-04-01$34.67$34.67RVU22B
2022-01-01$34.67$34.67RVU22A
2021-10-01$34.66$34.66RVU21D
2021-07-01$34.66$34.66RVU21C
2021-04-01$34.66$34.66RVU21B
2021-01-01$34.66$34.66RVU21A
2020-10-01$35.52$35.52RVU20D
2020-07-01$35.52$35.52RVU20C
2020-04-01$35.52$35.52RVU20B
2020-01-01$35.52$35.52RVU20A
2019-10-01$35.47$35.47RVU19D
2019-07-01$35.47$35.47RVU19C
2019-04-01$35.47$35.47RVU19B
2019-01-01$35.47$35.47RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
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 99452 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

99452 billing questions

Who reports 99452?

The treating or requesting physician or qualified health care professional reports it for their referral and coordination work. The consulting clinician reports a consultant-side code for their own work when appropriate.

How much time is required?

The requesting clinician must document 30 minutes of referral-service work. Count the clinician’s own work preparing and coordinating the consultation, not the consultant’s time.

Can 99452 be reported with 99446 or 99451?

They represent different clinicians’ work: 99452 is for the requester, while 99446–99449 and 99451 describe consultant-side services. When both clinicians perform and document their respective services, each selects the code matching their role and service.

Is 99452 the right code for the consultant’s report?

No. The requesting clinician uses 99452 for referral coordination; the consultant uses 99446–99449 or 99451 for the consultant’s assessment and response, as applicable.

What documentation supports 99452?

Document the clinical question, the information sent to the consultant, the requesting clinician’s referral and coordination activities, and the 30 minutes of work.

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 99452PPRRVU2026_Oct_nonQPP.csv, line 13,119 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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