Billing code 99483: Cognitive care planMedicare rate & RVUs

Medicare pays $292.93 for 99483 nationally in the office and $169.68 in a hospital or facility. Local office rates run $266.61–$371.65.

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

What 99483 covers

A physician or other eligible practitioner evaluates a patient with cognitive impairment, often using an independent historian such as a family member or caregiver. The service brings together a cognition-focused history and examination, standardized cognitive assessment, review of daily function and decision-making capacity, medication reconciliation, and assessment of behavioral symptoms, mood, and safety concerns such as driving. It also identifies caregiver needs, addresses advance care planning, and produces a written plan with referrals when appropriate. The service is commonly furnished in an office or other outpatient setting, and may also take place in a home or residential setting.

Report 99483 for the completed assessment and care-planning service, not separately for each element. The encounter typically takes 50 minutes face-to-face with the patient and/or caregiver. Documentation should identify the historian when used, record assessment findings and functional and safety concerns, and show the resulting care plan and referrals. Keep the documentation specific to the patient; a cognitive screening result alone does not establish that the comprehensive service was performed.

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 99483 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

99483 rates by state

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

How the 99483 rate is calculated

Each of 99483’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 99483

99483 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.

99483 compared with similar codes

How to choose

96116Neurobehavioral exam

Use 96116 for a neurobehavioral status examination. Use 99483 when the practitioner also completes the broader functional, safety, caregiver, and care-planning work.

96132Neuropsychological evaluation

96132 reports neuropsychological test evaluation work, including interpretation and clinical decision-making. It is not the comprehensive cognitive care-planning service represented by 99483.

99484Behavioral health management

99484 concerns behavioral health care management. 99483 is centered on assessing cognitive impairment and creating a patient-specific care plan.

99490Chronic care management

99490 describes ongoing chronic care management. 99483 is the comprehensive cognitive assessment and care-planning encounter, rather than monthly care-management work.

Codes related to 99483

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