CPT code 99446: Consultation2026 Medicare rate & RVUs

Medicare pays $19.04 for 99446 nationally in the office and $16.03 in a hospital or facility. Local office rates run $17.54–$24.67.

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

What 99446 covers

99446 is for a consultant physician’s brief remote review and discussion of a patient’s case with the treating or requesting clinician, followed by a written report. It is useful when a clinician needs specialty input on diagnosis or management without arranging a face-to-face visit with the consultant. For example, a primary care clinician may request a cardiologist’s advice about medication management in a patient with a complex cardiac history. The patient is not the other party to the clinician-to-clinician discussion.

Select this tier using the consultant’s time spent on the medical discussion and record review: 5–10 minutes supports 99446. Document the request and clinical question, relevant records reviewed, communication with the treating clinician, time, and written recommendations. The discussion, review, and report form parts of this consultative service. CMS assigns physician work and practice-expense values to the code in the physician fee schedule; the consultant reports the service, not the treating clinician’s referral-coordination work.

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 99446 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

99446 rates by state

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

How the 99446 rate is calculated

Each of 99446’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 99446

99446 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.

99446 compared with similar codes

How to choose

99447Interprofessional consult

Both represent verbal interprofessional consultation with review and a written report. Choose 99446 for 5–10 minutes and 99447 for 11–20 minutes.

99451E-consult

99446 includes a verbal discussion with the treating or requesting clinician. 99451 is the written-report-only pathway for the consultant’s remote review.

99452Referral coordination

99446 is reported by the consultant physician providing advice. 99452 represents the requesting clinician’s work coordinating the referral and preparing the case.

Codes related to 99446

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