FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

98016 in Chico

Office / nonfacility

$17.87

Base rate per service

Facility setting

$13.11

Base rate per service

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.

Telehealth service

About 98016: Brief established-patient virtual check-in

A physician or qualified health care professional reports this brief technology-based discussion with an established patient when it remains separate from a related visit.

This service covers a short medical discussion with an established patient using communication technology, such as a virtual check-in to address a new concern or determine whether an in-person evaluation is needed. It is performed by a physician or other qualified health care professional who can report evaluation and management services. The discussion must take 5 to 10 minutes and cannot be part of a related evaluation and management service from the prior 7 days or lead to an evaluation and management service or procedure within 24 hours or the soonest available appointment.

Report the code only when the documented communication meets those time and relationship criteria; record the issue discussed and the medical decision or advice given. A substantive evaluation and management encounter by synchronous audio or video is represented by the applicable telehealth E/M code instead. CMS assigns physician work, practice expense, and malpractice relative values to this service under the Physician Fee Schedule. The supplied CMS rules list no special payment instruction for this code.

Where the value comes from

  • Work RVU0.30 · 58%
  • Practice expense (office) RVU0.20 · 38%
  • Malpractice RVU0.02 · 4%

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.

98016 compared with similar codes

Office rates for Chico, from the same CMS release.

98012

Synch audio-only est sf 10

No office rate

98016 covers a brief 5-to-10-minute check-in; 98012 is an established-patient audio-only E/M service with its own service and time requirements.

98004

Synch audio-video est sf 10

No office rate

98016 is a brief technology-based discussion, while 98004 represents a synchronous audio-video E/M encounter for an established patient.

99421

Online E/M

5–10 minutes over seven days

$16.17

98016 is a brief communication service; 99421 is for qualifying asynchronous online digital E/M accumulated over the applicable service period.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 98016 is $17.94—$0.07 higher than the $17.87 rate in Chico. Both use the same code, release and participation basis.

98016 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $17.87

  2. Bakersfield

    $17.94

    $0.07 higher than Chico

  3. El Centro

    $17.87

    The same base rate than Chico

  4. Fresno

    $17.87

    The same base rate than Chico

  5. Hanford-Corcoran

    $17.87

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $18.78

    $0.91 higher than Chico

  7. Madera

    $17.87

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 98016 ranges from $16.10 in Arkansas to $22.51 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Modesto

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Napa

    California · 98016

    Office

    $19.80

    Facility

    $14.07

    $1.93 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 98016

    Office

    $18.61

    Facility

    $13.48

    $0.74 higher than Chico for the office setting.

  • Redding

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 98016

    Office

    $18.09

    Facility

    $13.33

    $0.22 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 98016

    Office

    $18.51

    Facility

    $13.46

    $0.64 higher than Chico for the office setting.

  • Salinas

    California · 98016

    Office

    $18.43

    Facility

    $13.40

    $0.56 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 98016

    Office

    $18.67

    Facility

    $13.48

    $0.80 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 98016

    Office

    $20.70

    Facility

    $14.58

    $2.83 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 98016

    Office

    $20.68

    Facility

    $14.55

    $2.81 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 98016

    Office

    $21.11

    Facility

    $14.85

    $3.24 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 98016

    Office

    $21.02

    Facility

    $14.76

    $3.15 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 98016

    Office

    $18.16

    Facility

    $13.21

    $0.29 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 98016

    Office

    $18.71

    Facility

    $13.43

    $0.84 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 98016

    Office

    $18.45

    Facility

    $13.39

    $0.58 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 98016

    Office

    $18.88

    Facility

    $13.55

    $1.01 higher than Chico for the office setting.

  • Stockton

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 98016

    Office

    $19.76

    Facility

    $14.04

    $1.89 higher than Chico for the office setting.

  • Visalia

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 98016

    Office

    $17.87

    Facility

    $13.11

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 98016

    Office

    $19.17

    Facility

    $14.06

    $1.30 higher than Chico for the office setting.

  • Miami

    Florida · 98016

    Office

    $18.66

    Facility

    $14.14

    $0.79 higher than Chico for the office setting.

  • Chicago

    Illinois · 98016

    Office

    $18.34

    Facility

    $13.97

    $0.47 higher than Chico for the office setting.

  • Manhattan

    New York · 98016

    Office

    $19.48

    Facility

    $14.44

    $1.61 higher than Chico for the office setting.

  • Alaska*

    Alaska · 98016

    Office

    $22.51

    Facility

    $17.89

    $4.64 higher than Chico for the office setting.

  • Alabama

    Alabama · 98016

    Office

    $16.24

    Facility

    $12.44

    $1.63 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 98016

    Office

    $16.10

    Facility

    $12.37

    $1.77 lower than Chico for the office setting.

  • Arizona

    Arizona · 98016

    Office

    $17.07

    Facility

    $12.86

    $0.80 lower than Chico for the office setting.

  • Colorado

    Colorado · 98016

    Office

    $17.77

    Facility

    $13.15

    $0.10 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 98016

    Office

    $18.22

    Facility

    $13.55

    $0.35 higher than Chico for the office setting.

  • Delaware

    Delaware · 98016

    Office

    $17.27

    Facility

    $12.98

    $0.60 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 98016

    Office

    $18.00

    Facility

    $13.60

    $0.13 higher than Chico for the office setting.

  • Rest Of Florida

    Florida · 98016

    Office

    $17.41

    Facility

    $13.26

    $0.46 lower than Chico for the office setting.

  • Atlanta

    Georgia · 98016

    Office

    $17.64

    Facility

    $13.23

    $0.23 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 98016

    Office

    $16.78

    Facility

    $12.90

    $1.09 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 98016

    Office

    $18.00

    Facility

    $13.07

    $0.13 higher than Chico for the office setting.

  • Iowa

    Iowa · 98016

    Office

    $16.40

    Facility

    $12.42

    $1.47 lower than Chico for the office setting.

  • Idaho

    Idaho · 98016

    Office

    $16.48

    Facility

    $12.49

    $1.39 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 98016

    Office

    $17.51

    Facility

    $13.52

    $0.36 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 98016

    Office

    $17.16

    Facility

    $13.20

    $0.71 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 98016

    Office

    $18.13

    Facility

    $13.68

    $0.26 higher than Chico for the office setting.

  • Indiana

    Indiana · 98016

    Office

    $16.54

    Facility

    $12.51

    $1.33 lower than Chico for the office setting.

  • Kansas

    Kansas · 98016

    Office

    $16.40

    Facility

    $12.47

    $1.47 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 98016

    Office

    $16.57

    Facility

    $12.71

    $1.30 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 98016

    Office

    $17.07

    Facility

    $12.98

    $0.80 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 98016

    Office

    $16.57

    Facility

    $12.73

    $1.30 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 98016

    Office

    $19.00

    Facility

    $13.82

    $1.13 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 98016

    Office

    $17.75

    Facility

    $13.17

    $0.12 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 98016

    Office

    $18.17

    Facility

    $13.52

    $0.30 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 98016

    Office

    $17.49

    Facility

    $13.10

    $0.38 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 98016

    Office

    $16.58

    Facility

    $12.59

    $1.29 lower than Chico for the office setting.

  • Southern Maine

    Maine · 98016

    Office

    $17.06

    Facility

    $12.76

    $0.81 lower than Chico for the office setting.

  • Detroit

    Michigan · 98016

    Office

    $17.59

    Facility

    $13.40

    $0.28 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 98016

    Office

    $16.87

    Facility

    $12.91

    $1.00 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 98016

    Office

    $17.09

    Facility

    $12.62

    $0.78 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 98016

    Office

    $16.95

    Facility

    $12.87

    $0.92 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 98016

    Office

    $17.05

    Facility

    $12.92

    $0.82 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 98016

    Office

    $16.43

    Facility

    $12.69

    $1.44 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 98016

    Office

    $16.27

    Facility

    $12.53

    $1.60 lower than Chico for the office setting.

  • Montana**

    Montana · 98016

    Office

    $17.37

    Facility

    $13.03

    $0.50 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 98016

    Office

    $16.68

    Facility

    $12.63

    $1.19 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 98016

    Office

    $16.97

    Facility

    $12.63

    $0.90 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 98016

    Office

    $16.44

    Facility

    $12.43

    $1.43 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 98016

    Office

    $17.56

    Facility

    $13.04

    $0.31 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 98016

    Office

    $19.11

    Facility

    $14.08

    $1.24 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 98016

    Office

    $18.45

    Facility

    $13.71

    $0.58 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 98016

    Office

    $16.95

    Facility

    $12.97

    $0.92 lower than Chico for the office setting.

  • Nevada**

    Nevada · 98016

    Office

    $17.26

    Facility

    $12.92

    $0.61 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 98016

    Office

    $19.84

    Facility

    $14.68

    $1.97 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 98016

    Office

    $18.59

    Facility

    $13.84

    $0.72 higher than Chico for the office setting.

  • Queens

    New York · 98016

    Office

    $19.52

    Facility

    $14.39

    $1.65 higher than Chico for the office setting.

  • Rest Of New York

    New York · 98016

    Office

    $16.84

    Facility

    $12.71

    $1.03 lower than Chico for the office setting.

  • Ohio

    Ohio · 98016

    Office

    $16.79

    Facility

    $12.83

    $1.08 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 98016

    Office

    $16.50

    Facility

    $12.63

    $1.37 lower than Chico for the office setting.

  • Portland

    Oregon · 98016

    Office

    $18.10

    Facility

    $13.28

    $0.23 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 98016

    Office

    $17.14

    Facility

    $12.82

    $0.73 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 98016

    Office

    $17.95

    Facility

    $13.43

    $0.08 higher than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 98016

    Office

    $16.78

    Facility

    $12.80

    $1.09 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 98016

    Office

    $17.43

    Facility

    $13.04

    $0.44 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 98016

    Office

    $17.71

    Facility

    $13.22

    $0.16 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 98016

    Office

    $16.76

    Facility

    $12.75

    $1.11 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 98016

    Office

    $16.92

    Facility

    $12.58

    $0.95 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 98016

    Office

    $16.45

    Facility

    $12.50

    $1.42 lower than Chico for the office setting.

  • Austin

    Texas · 98016

    Office

    $17.70

    Facility

    $13.11

    $0.17 lower than Chico for the office setting.

  • Beaumont

    Texas · 98016

    Office

    $16.72

    Facility

    $12.77

    $1.15 lower than Chico for the office setting.

  • Brazoria

    Texas · 98016

    Office

    $17.24

    Facility

    $12.94

    $0.63 lower than Chico for the office setting.

  • Dallas

    Texas · 98016

    Office

    $17.34

    Facility

    $13.01

    $0.53 lower than Chico for the office setting.

  • Fort Worth

    Texas · 98016

    Office

    $17.28

    Facility

    $13.00

    $0.59 lower than Chico for the office setting.

  • Galveston

    Texas · 98016

    Office

    $17.29

    Facility

    $12.98

    $0.58 lower than Chico for the office setting.

  • Houston

    Texas · 98016

    Office

    $17.65

    Facility

    $13.34

    $0.22 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 98016

    Office

    $16.96

    Facility

    $12.84

    $0.91 lower than Chico for the office setting.

  • Utah

    Utah · 98016

    Office

    $16.90

    Facility

    $12.82

    $0.97 lower than Chico for the office setting.

  • Virginia

    Virginia · 98016

    Office

    $17.06

    Facility

    $12.79

    $0.81 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 98016

    Office

    $17.43

    Facility

    $13.04

    $0.44 lower than Chico for the office setting.

  • Vermont

    Vermont · 98016

    Office

    $16.97

    Facility

    $12.67

    $0.90 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 98016

    Office

    $17.69

    Facility

    $13.12

    $0.18 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 98016

    Office

    $19.26

    Facility

    $13.94

    $1.39 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 98016

    Office

    $16.63

    Facility

    $12.47

    $1.24 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 98016

    Office

    $16.78

    Facility

    $13.01

    $1.09 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 98016

    Office

    $17.19

    Facility

    $12.85

    $0.68 lower than Chico for the office setting.

See how rates vary across the country

98016 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$16.10

$22.51

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$22.511
AL$16.241
AR$16.101
AZ$17.071
CA$17.87–$21.1129
CO$17.771
CT$18.221
DC$19.171
DE$17.271
FL$17.41–$18.663
GA$16.78–$17.642
GU$18.001
HI$18.001
IA$16.401
ID$16.481
IL$17.16–$18.344
IN$16.541
KS$16.401
KY$16.571
LA$16.57–$17.072
MA$17.75–$19.002
MD$17.49–$19.173
ME$16.58–$17.062
MI$16.87–$17.592
MN$17.091
MO$16.43–$17.053
MS$16.271
MT$17.371
NC$16.681
ND$16.971
NE$16.441
NH$17.561
NJ$18.45–$19.112
NM$16.951
NV$17.261
NY$16.84–$19.845
OH$16.791
OK$16.501
OR$17.14–$18.102
PA$16.78–$17.952
PR$17.431
RI$17.711
SC$16.761
SD$16.921
TN$16.451
TX$16.72–$17.708
UT$16.901
VA$17.06–$19.172
VI$17.431
VT$16.971
WA$17.69–$19.262
WI$16.631
WV$16.781
WY$17.191

Explore 98016 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 98016 in Chico, the physician’s office rate is $17.87 and the facility-setting rate is $13.11: a difference of $4.76.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 98016 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$19.66

$17.87 × 110% = $19.66

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 98016 in Chico.

PPRRVU2026_Oct_nonQPP.csv

12,936

Code
98016
Physician work
0.30
Practice expense
0.20
Malpractice
0.02

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 98016 in Chico
ComponentRVULocality factorAdjusted
Physician work0.30× 1.0170.3051
Practice expense0.20× 1.0960.2192
Malpractice0.02× 0.5360.0107
Total RVUs0.5350
Conversion factor× 33.4009

Office / nonfacility rate, Chico$17.87

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 98016 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.31.017
Practice expense0.21.096
Malpractice0.020.536

(0.3 × 1.017 + 0.2 × 1.096 + 0.02 × 0.536) × $33.4009 = $17.87

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.31.017
Practice expense0.071.096
Malpractice0.020.536

(0.3 × 1.017 + 0.07 × 1.096 + 0.02 × 0.536) × $33.4009 = $13.11

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

98016 · Office / nonfacility

$17.87

Effective 2026-10-01

The base rate is $1.66 higher than on 2025-10-01, moving from $16.21 to $17.87 (10.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $16.21changed to$17.87

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.17 changed to 0.20
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $16.21

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$17.87$13.11RVU26D
2026-07-01$17.87$13.11RVU26C
2026-04-01$17.87$13.11RVU26B
2026-01-01$17.87$13.11RVU26A
2025-10-01$16.21$14.80RVU25D
2025-07-01$16.21$14.80RVU25C
2025-04-01$16.21$14.80RVU25B
2025-01-01$16.21$14.80RVU25A

98016 billing questions

How does this differ from an established-patient audio-only E/M service?

98016 is for a 5-to-10-minute brief medical discussion. Use an audio-only E/M code when the encounter is a substantive E/M service that meets that code's requirements.

Can the check-in be billed when it leads to an office visit?

Do not report 98016 when it leads to an E/M service or procedure within the next 24 hours or the soonest available appointment.

Can it be billed after a related E/M visit?

No. The communication cannot originate from a related E/M service provided during the previous 7 days.

What time should the record support?

Document 5 to 10 minutes of medical discussion, along with the concern addressed and the advice or decision reached.

Is this code for a new patient?

No. The service is limited to an established patient.

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.

RVUs for 98016PPRRVU2026_Oct_nonQPP.csv, line 12,936 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet