$35.20–$49.52
Use 99447 for 11–20 minutes of qualifying consultant work; 99448 covers 21–30 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
99448 Interprofessional consultation Medicare reimbursement rates
A consulting physician reviews a patient’s clinical information and gives the treating clinician verbal and written guidance after 21–30 minutes of work. Compare 99448 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99448?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$52.69–$74.18
109 of 109 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 99448 pays more and less
109 payment localities
$52.69 to $74.18
Interprofessional consultation
About 99448: Interprofessional consultation, 21–30 minutes
A consulting physician reviews a patient’s clinical information and gives the treating clinician verbal and written guidance after 21–30 minutes of work.
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.
Where the value comes from
- Work RVU1.05 · 62%
- Practice expense (office) RVU0.56 · 33%
- Malpractice RVU0.09 · 5%
9.2K
Medicare services in 2024 · #1521 by national volume
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.
99448 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$70.63–$99.39
Use 99449 when qualifying consultant work reaches 31 minutes or more; 99448 is for 21–30 minutes.
$33.14–$47.02
99451 is the consultant-service option with a written report and a different time threshold. 99448 requires both verbal communication and a written report for 21–30 minutes.
$34.57–$48.80
99452 describes the requesting clinician’s work preparing for and coordinating the referral; 99448 describes the consulting physician’s assessment and recommendations.
See how rates vary across the country
99448 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $74.18 | 1 |
| AL | $53.14 | 1 |
| AR | $52.69 | 1 |
| AZ | $55.77 | 1 |
| CA | $57.78–$67.51 | 29 |
| CO | $57.74 | 1 |
| CT | $59.55 | 1 |
| DC | $62.34 | 1 |
| DE | $56.43 | 1 |
| FL | $57.47–$62.14 | 3 |
| GA | $55.34–$57.79 | 2 |
| GU | $58.08 | 1 |
| HI | $58.08 | 1 |
| IA | $53.38 | 1 |
| ID | $53.70 | 1 |
| IL | $56.85–$61.01 | 4 |
| IN | $53.87 | 1 |
| KS | $53.49 | 1 |
| KY | $54.45 | 1 |
| LA | $54.50–$56.09 | 2 |
| MA | $57.72–$61.52 | 2 |
| MD | $57.11–$62.34 | 3 |
| ME | $54.15–$55.50 | 2 |
| MI | $55.54–$58.19 | 2 |
| MN | $55.21 | 1 |
| MO | $54.12–$55.89 | 3 |
| MS | $53.40 | 1 |
| MT | $56.78 | 1 |
| NC | $54.44 | 1 |
| ND | $55.00 | 1 |
| NE | $53.47 | 1 |
| NH | $57.17 | 1 |
| NJ | $60.20–$62.19 | 2 |
| NM | $55.83 | 1 |
| NV | $56.30 | 1 |
| NY | $54.95–$65.14 | 5 |
| OH | $55.18 | 1 |
| OK | $54.11 | 1 |
| OR | $55.81–$58.65 | 2 |
| PA | $55.08–$58.76 | 2 |
| PR | $56.94 | 1 |
| RI | $57.74 | 1 |
| SC | $54.91 | 1 |
| SD | $54.79 | 1 |
| TN | $53.69 | 1 |
| TX | $54.88–$58.06 | 8 |
| UT | $55.35 | 1 |
| VA | $55.58–$62.34 | 2 |
| VI | $56.94 | 1 |
| VT | $55.11 | 1 |
| WA | $57.51–$62.23 | 2 |
| WI | $53.92 | 1 |
| WV | $55.63 | 1 |
| WY | $56.00 | 1 |
Compare 99448 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $53.14 | Facility $45.25 |
| Alaska* | Office $74.18 | Facility $64.58 |
| Arizona | Office $55.77 | Facility $47.03 |
| Arkansas | Office $52.69 | Facility $44.94 |
| Atlanta | Office $57.79 | Facility $48.63 |
| Austin | Office $57.59 | Facility $48.05 |
| Bakersfield | Office $58.07 | Facility $48.18 |
| Baltimore/Surr. Cntys | Office $59.42 | Facility $49.74 |
| Beaumont | Office $54.88 | Facility $46.68 |
| Brazoria | Office $56.23 | Facility $47.30 |
| Chicago | Office $61.01 | Facility $51.95 |
| Chico | Office $57.78 | Facility $47.89 |
| Colorado | Office $57.74 | Facility $48.15 |
| Connecticut | Office $59.55 | Facility $49.84 |
| Dallas | Office $56.60 | Facility $47.61 |
| Dc + Md/Va Suburbs | Office $62.34 | Facility $51.72 |
| Delaware | Office $56.43 | Facility $47.52 |
| Detroit | Office $58.19 | Facility $49.49 |
| East St. Louis | Office $58.33 | Facility $50.04 |
| El Centro | Office $57.79 | Facility $47.91 |
| Fort Lauderdale | Office $59.45 | Facility $50.32 |
| Fort Worth | Office $56.45 | Facility $47.56 |
| Fresno | Office $57.78 | Facility $47.89 |
| Galveston | Office $56.41 | Facility $47.46 |
| Hanford-Corcoran | Office $57.78 | Facility $47.89 |
| Hawaii, Guam | Office $58.08 | Facility $47.82 |
| Houston | Office $58.06 | Facility $49.11 |
| Idaho | Office $53.70 | Facility $45.40 |
| Indiana | Office $53.87 | Facility $45.51 |
| Iowa | Office $53.38 | Facility $45.13 |
| Kansas | Office $53.49 | Facility $45.34 |
| Kentucky | Office $54.45 | Facility $46.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $60.63 | Facility $49.96 |
| Madera | Office $57.78 | Facility $47.89 |
| Manhattan | Office $63.82 | Facility $53.34 |
| Merced | Office $57.78 | Facility $47.89 |
| Metropolitan Boston | Office $61.52 | Facility $50.75 |
| Metropolitan Kansas City | Office $55.57 | Facility $47.10 |
| Metropolitan Philadelphia | Office $58.76 | Facility $49.37 |
| Metropolitan St. Louis | Office $55.89 | Facility $47.30 |
| Miami | Office $62.14 | Facility $52.76 |
| Minnesota | Office $55.21 | Facility $45.93 |
| Mississippi | Office $53.40 | Facility $45.63 |
| Modesto | Office $57.78 | Facility $47.89 |
| Montana** | Office $56.78 | Facility $47.76 |
| Napa | Office $63.46 | Facility $51.57 |
| Nebraska | Office $53.47 | Facility $45.15 |
| Nevada** | Office $56.30 | Facility $47.27 |
| New Hampshire | Office $57.17 | Facility $47.78 |
| New Mexico | Office $55.83 | Facility $47.56 |
| New Orleans | Office $56.09 | Facility $47.60 |
| North Carolina | Office $54.44 | Facility $46.03 |
| North Dakota** | Office $55.00 | Facility $45.98 |
| Northern Nj | Office $62.19 | Facility $51.73 |
| Nyc Suburbs/Long Island | Office $65.14 | Facility $54.41 |
| Ohio | Office $55.18 | Facility $46.94 |
| Oklahoma | Office $54.11 | Facility $46.06 |
| Oxnard-Thousand Oaks-Ventura | Office $60.03 | Facility $49.37 |
| Portland | Office $58.65 | Facility $48.63 |
| Poughkpsie/N Nyc Suburbs | Office $60.77 | Facility $50.89 |
| Puerto Rico | Office $56.94 | Facility $47.82 |
| Queens | Office $63.76 | Facility $53.10 |
| Redding | Office $57.78 | Facility $47.89 |
| Rest Of California | Office $57.78 | Facility $47.89 |
| Rest Of Florida | Office $57.47 | Facility $48.85 |
| Rest Of Georgia | Office $55.34 | Facility $47.29 |
| Rest Of Illinois | Office $56.85 | Facility $48.61 |
| Rest Of Louisiana | Office $54.50 | Facility $46.52 |
| Rest Of Maine | Office $54.15 | Facility $45.85 |
| Rest Of Maryland | Office $57.11 | Facility $47.98 |
| Rest Of Massachusetts | Office $57.72 | Facility $48.23 |
| Rest Of Michigan | Office $55.54 | Facility $47.31 |
| Rest Of Missouri | Office $54.12 | Facility $46.35 |
| Rest Of New Jersey | Office $60.20 | Facility $50.35 |
| Rest Of New York | Office $54.95 | Facility $46.39 |
| Rest Of Oregon | Office $55.81 | Facility $46.83 |
| Rest Of Pennsylvania | Office $55.08 | Facility $46.80 |
| Rest Of Texas | Office $55.54 | Facility $46.98 |
| Rest Of Washington | Office $57.51 | Facility $48.01 |
| Rhode Island | Office $57.74 | Facility $48.42 |
| Riverside-San Bernardino-Ontario | Office $58.77 | Facility $48.88 |
| Sacramento-Roseville-Folsom | Office $59.70 | Facility $49.21 |
| Salinas | Office $59.45 | Facility $49.00 |
| San Diego-Chula Vista-Carlsbad | Office $60.12 | Facility $49.34 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $66.16 | Facility $53.44 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $66.05 | Facility $53.34 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $67.51 | Facility $54.51 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $67.09 | Facility $54.09 |
| San Luis Obispo-Paso Robles | Office $58.58 | Facility $48.31 |
| Santa Cruz-Watsonville | Office $60.14 | Facility $49.19 |
| Santa Maria-Santa Barbara | Office $59.47 | Facility $48.96 |
| Santa Rosa-Petaluma | Office $60.70 | Facility $49.63 |
| Seattle (King Cnty) | Office $62.23 | Facility $51.17 |
| South Carolina | Office $54.91 | Facility $46.58 |
| South Dakota** | Office $54.79 | Facility $45.77 |
| Southern Maine | Office $55.50 | Facility $46.57 |
| Stockton | Office $57.78 | Facility $47.89 |
| Suburban Chicago | Office $59.85 | Facility $50.59 |
| Tennessee | Office $53.69 | Facility $45.49 |
| Utah | Office $55.35 | Facility $46.88 |
| Vallejo | Office $63.31 | Facility $51.43 |
| Vermont | Office $55.11 | Facility $46.18 |
| Virgin Islands | Office $56.94 | Facility $47.82 |
| Virginia | Office $55.58 | Facility $46.71 |
| Visalia | Office $57.78 | Facility $47.89 |
| West Virginia | Office $55.63 | Facility $47.79 |
| Wisconsin | Office $53.92 | Facility $45.28 |
| Wyoming** | Office $56.00 | Facility $46.98 |
| Yuba City | Office $57.78 | Facility $47.89 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,11299445,,Rem mntr physiol param 2-15,A,,0.00,1.55,,1.55,NA,0.01,1.56,1.56,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11399446,,Ntrprof ph1/ntrnet/ehr 5-10,A,,0.35,0.18,,0.09,,0.04,0.57,0.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11499447,,Ntrprof ph1/ntrnet/ehr 11-20,A,,0.70,0.37,,0.19,,0.07,1.14,0.96,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11599448,,Ntrprof ph1/ntrnet/ehr 21-30,A,,1.05,0.56,,0.29,,0.09,1.70,1.43,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11699449,,Ntrprof ph1/ntrnet/ehr 31/>,A,,1.40,0.76,,0.38,,0.12,2.28,1.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11799450,,Basic life disability exam,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11899451,,Ntrprof ph1/ntrnet/ehr 5/>,A,,0.70,0.31,,0.15,,0.05,1.06,0.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00