CPT code 99460: Newborn care, initial hospital day2026 Medicare rate & RVUs

Medicare pays $80.83 for 99460 nationally in a facility.

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

What 99460 covers

A physician or other qualified health professional reports this service for the initial evaluation and management of a normal newborn in a hospital or birthing center. The encounter typically includes review of pregnancy and delivery information, a newborn examination, assessment of the infant’s status, and a plan for routine care. Pediatricians, neonatologists, and family physicians commonly provide this care.

Select 99460 when the clinician provides the initial normal-newborn hospital or birthing-center care for that day. The record should support the newborn’s normal status and document the assessment and care plan. The code is reported per day, rather than by time spent. Use the subsequent-day newborn service when care continues on a later hospital day, or the same-day discharge service when the initial evaluation and discharge occur on the same date.

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.

Where 99460 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99460 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 99460 rate is calculated

Each of 99460’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.

Payment rules and modifiers for 99460

99460 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.

99460 compared with similar codes

How to choose

99461Newborn careInitial, non-facility setting

99460 is for initial care in a hospital or birthing center; 99461 is for initial normal-newborn care outside those settings.

99462Newborn careSubsequent hospital day

Use 99460 for initial-day normal-newborn care and 99462 for subsequent-day care during the same hospitalization.

99463Newborn careAdmission and discharge same day

99463 applies when initial normal-newborn care and discharge take place on the same date; 99460 applies when the newborn remains in care.

99468Neonatal critical careInitial day

99460 is for a normal newborn’s routine hospital care. 99468 is for initial-day neonatal critical care when the infant is critically ill or injured.

Codes related to 99460

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates