No office rate
99460 reports initial hospital or birthing-center care without the same-day admission-and-discharge circumstance that defines 99463.
On this page
CMS RVU26D · Effective 2026-10-01
99463 Newborn care Medicare reimbursement rates
Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date. Compare 99463 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 99463?
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
No 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 99463 pays more and less
Newborn care
About 99463: Same-day newborn hospital care
Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date.
This service covers the same-day hospital or birthing-center care of a normal newborn, including the initial evaluation and management and the discharge-related care. It is typically performed by a physician or other qualified clinician responsible for the newborn’s care during the stay. The code is specific to a newborn admitted and discharged on the same calendar date; it is not the selection for a newborn who remains admitted for a later date.
Report one same-day episode for the infant rather than separate newborn-care entries for admission and discharge. Documentation should support the newborn’s normal status, the initial assessment and management, and the same-date admission and discharge. The CMS physician fee schedule assigns physician-work and practice-expense values to this service. Choose among newborn-care codes according to the care setting, whether the service is initial or subsequent, and whether discharge occurs that day.
Where the value comes from
- Work RVU2.13 · 75%
- Practice expense (office) RVU0.58 · 20%
- Malpractice RVU0.13 · 5%
33
Medicare services in 2024 · #5607 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.
99463 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$85.75–$119.25
99461 is for initial newborn care outside a hospital or birthing center; 99463 is for the same-day episode in a hospital or birthing center.
No office rate
99462 applies to subsequent daily care when the newborn remains admitted. 99463 covers initial and discharge-related care when both occur on the same date.
See how rates vary across the country
99463 · 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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 99463 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 Unavailable | Facility $90.55 |
| Alaska* | Office Unavailable | Facility $129.74 |
| Arizona | Office Unavailable | Facility $93.63 |
| Arkansas | Office Unavailable | Facility $90.02 |
| Atlanta | Office Unavailable | Facility $96.25 |
| Austin | Office Unavailable | Facility $95.63 |
| Bakersfield | Office Unavailable | Facility $96.37 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $98.44 |
| Beaumont | Office Unavailable | Facility $92.81 |
| Brazoria | Office Unavailable | Facility $94.30 |
| Chicago | Office Unavailable | Facility $101.08 |
| Chico | Office Unavailable | Facility $95.91 |
| Colorado | Office Unavailable | Facility $96.00 |
| Connecticut | Office Unavailable | Facility $98.68 |
| Dallas | Office Unavailable | Facility $94.80 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $102.64 |
| Delaware | Office Unavailable | Facility $94.54 |
| Detroit | Office Unavailable | Facility $97.16 |
| East St. Louis | Office Unavailable | Facility $97.71 |
| El Centro | Office Unavailable | Facility $95.93 |
| Fort Lauderdale | Office Unavailable | Facility $98.62 |
| Fort Worth | Office Unavailable | Facility $94.67 |
| Fresno | Office Unavailable | Facility $95.91 |
| Galveston | Office Unavailable | Facility $94.55 |
| Hanford-Corcoran | Office Unavailable | Facility $95.91 |
| Hawaii, Guam | Office Unavailable | Facility $95.68 |
| Houston | Office Unavailable | Facility $96.92 |
| Idaho | Office Unavailable | Facility $91.02 |
| Indiana | Office Unavailable | Facility $91.21 |
| Iowa | Office Unavailable | Facility $90.59 |
| Kansas | Office Unavailable | Facility $90.85 |
| Kentucky | Office Unavailable | Facility $92.34 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $99.86 |
| Madera | Office Unavailable | Facility $95.91 |
| Manhattan | Office Unavailable | Facility $105.09 |
| Merced | Office Unavailable | Facility $95.91 |
| Metropolitan Boston | Office Unavailable | Facility $101.06 |
| Metropolitan Kansas City | Office Unavailable | Facility $93.58 |
| Metropolitan Philadelphia | Office Unavailable | Facility $97.77 |
| Metropolitan St. Louis | Office Unavailable | Facility $93.94 |
| Miami | Office Unavailable | Facility $102.29 |
| Minnesota | Office Unavailable | Facility $92.36 |
| Mississippi | Office Unavailable | Facility $91.03 |
| Modesto | Office Unavailable | Facility $95.91 |
| Montana** | Office Unavailable | Facility $94.85 |
| Napa | Office Unavailable | Facility $103.36 |
| Nebraska | Office Unavailable | Facility $90.67 |
| Nevada** | Office Unavailable | Facility $94.15 |
| New Hampshire | Office Unavailable | Facility $95.11 |
| New Mexico | Office Unavailable | Facility $94.12 |
| New Orleans | Office Unavailable | Facility $94.31 |
| North Carolina | Office Unavailable | Facility $91.99 |
| North Dakota** | Office Unavailable | Facility $92.28 |
| Northern Nj | Office Unavailable | Facility $102.74 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $106.79 |
| Ohio | Office Unavailable | Facility $93.21 |
| Oklahoma | Office Unavailable | Facility $91.82 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $98.74 |
| Portland | Office Unavailable | Facility $97.04 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $100.81 |
| Puerto Rico | Office Unavailable | Facility $95.01 |
| Queens | Office Unavailable | Facility $104.86 |
| Redding | Office Unavailable | Facility $95.91 |
| Rest Of California | Office Unavailable | Facility $95.91 |
| Rest Of Florida | Office Unavailable | Facility $96.19 |
| Rest Of Georgia | Office Unavailable | Facility $93.60 |
| Rest Of Illinois | Office Unavailable | Facility $95.62 |
| Rest Of Louisiana | Office Unavailable | Facility $92.45 |
| Rest Of Maine | Office Unavailable | Facility $91.67 |
| Rest Of Maryland | Office Unavailable | Facility $95.45 |
| Rest Of Massachusetts | Office Unavailable | Facility $96.14 |
| Rest Of Michigan | Office Unavailable | Facility $93.73 |
| Rest Of Missouri | Office Unavailable | Facility $92.07 |
| Rest Of New Jersey | Office Unavailable | Facility $99.91 |
| Rest Of New York | Office Unavailable | Facility $92.60 |
| Rest Of Oregon | Office Unavailable | Facility $93.49 |
| Rest Of Pennsylvania | Office Unavailable | Facility $93.03 |
| Rest Of Texas | Office Unavailable | Facility $93.45 |
| Rest Of Washington | Office Unavailable | Facility $95.77 |
| Rhode Island | Office Unavailable | Facility $96.38 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $97.36 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $98.56 |
| Salinas | Office Unavailable | Facility $98.13 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $98.80 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $107.21 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $107.06 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $109.23 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $108.63 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $96.75 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $98.50 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $98.05 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $99.40 |
| Seattle (King Cnty) | Office Unavailable | Facility $102.02 |
| South Carolina | Office Unavailable | Facility $92.73 |
| South Dakota** | Office Unavailable | Facility $91.98 |
| Southern Maine | Office Unavailable | Facility $93.08 |
| Stockton | Office Unavailable | Facility $95.91 |
| Suburban Chicago | Office Unavailable | Facility $99.23 |
| Tennessee | Office Unavailable | Facility $91.09 |
| Utah | Office Unavailable | Facility $93.25 |
| Vallejo | Office Unavailable | Facility $103.15 |
| Vermont | Office Unavailable | Facility $92.52 |
| Virgin Islands | Office Unavailable | Facility $95.01 |
| Virginia | Office Unavailable | Facility $93.25 |
| Visalia | Office Unavailable | Facility $95.91 |
| West Virginia | Office Unavailable | Facility $94.19 |
| Wisconsin | Office Unavailable | Facility $91.04 |
| Wyoming** | Office Unavailable | Facility $93.73 |
| Yuba City | Office Unavailable | Facility $95.91 |
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99463 billing questions
When should 99463 be used instead of 99460?
Use 99463 when the normal newborn is admitted to a hospital or birthing center and discharged on the same date. Use 99460 for initial hospital or birthing-center newborn care when the same-day discharge circumstance does not apply.
Can 99463 be reported for newborn care outside a hospital or birthing center?
No. For initial care of a normal newborn in a non-facility setting, consider 99461 instead.
How does 99463 differ from 99462?
99463 represents the same-day admission and discharge episode. 99462 is for subsequent daily care of a normal newborn who remains in the hospital or birthing center.
Should admission and discharge be coded as two separate newborn-care services?
No. 99463 represents the same-day newborn-care episode, including the initial and discharge-related care.
What documentation supports 99463?
Document the newborn’s normal status, the initial evaluation and management, and the admission and discharge dates showing both occurred on the same date.
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.
13,12799460,,Init nb em per day hosp,A,,1.92,0.38,NA,0.38,,0.12,2.42,2.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12899461,,Init nb em per day non-fac,A,,1.26,1.48,,0.26,,0.07,2.81,1.59,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12999462,,Sbsq nb em per day hosp,A,,0.84,0.17,NA,0.17,,0.05,1.06,1.06,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13099463,,Same day nb discharge,A,,2.13,0.58,NA,0.58,,0.13,2.84,2.84,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13199464,,Attendance at delivery,A,,1.50,0.31,NA,0.31,,0.08,1.89,1.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13299465,,Nb resuscitation,A,,2.93,0.59,NA,0.59,,0.18,3.70,3.70,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13399466,,Ped crit care transport,A,,4.79,0.97,NA,0.97,,0.28,6.04,6.04,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00