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CMS RVU26D · Effective 2026-10-01

99424 in Wyoming**

Office / nonfacility

$86.56

Base rate per service

Facility setting

$63.84

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.

Care management

About 99424: Physician principal care management, first 30 minutes

Reports the first 30 minutes of monthly physician or qualified health professional care management for one complex, high-risk chronic condition.

A physician or other qualified health care professional reports this monthly service for management of one complex chronic condition expected to last at least three months and placing the patient at significant risk of hospitalization, functional decline, or another serious outcome. The work centers on a disease-specific care plan and ongoing management, such as coordinating input among treating clinicians or adjusting the plan as the condition changes. It may be furnished in an office or other setting where the practitioner manages the patient’s care.

Report 99424 once for a calendar month when the physician or qualified health care professional personally provides at least 30 minutes of qualifying principal care management work. The record should identify the condition, its risk and management needs, the care plan, and the practitioner’s time and activities. This is not the staff-time code: clinical staff time is represented by 99426 and 99427. CMS fee-schedule valuation includes physician work, practice expense, and malpractice components.

Where the value comes from

  • Work RVU1.45 · 55%
  • Practice expense (office) RVU1.06 · 40%
  • Malpractice RVU0.11 · 4%

85K

Medicare services in 2024 · #611 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.

99424 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

99425

Principal care management

Each additional 30 minutes

$60.85

99424 covers the first 30 minutes of physician or qualified health professional principal care management in the month; 99425 covers each additional 30 minutes.

99426

Principal care management

Clinical staff, initial 30 minutes

$67.20

99426 is the staff-time counterpart for the first 30 minutes. Use 99424 for qualifying time personally furnished by the physician or qualified health professional.

99491

Chronic care management

30 minutes, physician/QHP time

$88.40

99491 is physician or qualified health professional chronic care management. 99424 is focused on one complex, high-risk chronic condition and its principal care plan.

The same code, a different location

How does Wyoming** compare?

99424 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $86.56

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

    $94.74

    $8.18 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $96.84

    $10.28 higher than Wyoming**

  4. Miami

    $94.58

    $8.02 higher than Wyoming**

  5. Chicago

    $92.78

    $6.22 higher than Wyoming**

  6. Manhattan

    $98.50

    $11.94 higher than Wyoming**

  7. Alaska*

    $112.38

    $25.82 higher than Wyoming**

Other payment areas listed in Wyoming 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, 99424 ranges from $80.74 in Arkansas to $112.38 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

  • Alabama

    Alabama · 99424

    Office

    $81.49

    Facility

    $61.62

    $5.07 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 99424

    Office

    $80.74

    Facility

    $61.23

    $5.82 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 99424

    Office

    $85.88

    Facility

    $63.88

    $0.68 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 99424

    Office

    $90.39

    Facility

    $65.50

    $3.83 higher than Wyoming** for the office setting.

  • Chico

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • El Centro

    California · 99424

    Office

    $90.05

    Facility

    $65.15

    $3.49 higher than Wyoming** for the office setting.

  • Fresno

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Madera

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Merced

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Modesto

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Napa

    California · 99424

    Office

    $100.01

    Facility

    $70.08

    $13.45 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99424

    Office

    $93.93

    Facility

    $67.08

    $7.37 higher than Wyoming** for the office setting.

  • Redding

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99424

    Office

    $91.24

    Facility

    $66.35

    $4.68 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99424

    Office

    $93.32

    Facility

    $66.91

    $6.76 higher than Wyoming** for the office setting.

  • Salinas

    California · 99424

    Office

    $92.94

    Facility

    $66.61

    $6.38 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99424

    Office

    $94.22

    Facility

    $67.06

    $7.66 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99424

    Office

    $104.64

    Facility

    $72.61

    $18.08 higher than Wyoming** for the office setting.

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

    California · 99424

    Office

    $104.51

    Facility

    $72.49

    $17.95 higher than Wyoming** for the office setting.

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

    California · 99424

    Office

    $106.78

    Facility

    $74.03

    $20.22 higher than Wyoming** for the office setting.

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

    California · 99424

    Office

    $106.27

    Facility

    $73.52

    $19.71 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99424

    Office

    $91.55

    Facility

    $65.68

    $4.99 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 99424

    Office

    $94.43

    Facility

    $66.84

    $7.87 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 99424

    Office

    $93.04

    Facility

    $66.56

    $6.48 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 99424

    Office

    $95.33

    Facility

    $67.44

    $8.77 higher than Wyoming** for the office setting.

  • Stockton

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Vallejo

    California · 99424

    Office

    $99.83

    Facility

    $69.90

    $13.27 higher than Wyoming** for the office setting.

  • Visalia

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Yuba City

    California · 99424

    Office

    $90.03

    Facility

    $65.13

    $3.47 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 99424

    Office

    $89.55

    Facility

    $65.39

    $2.99 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 99424

    Office

    $91.98

    Facility

    $67.52

    $5.42 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 99424

    Office

    $86.96

    Facility

    $64.52

    $0.40 higher than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 99424

    Office

    $90.94

    Facility

    $67.93

    $4.38 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 99424

    Office

    $87.80

    Facility

    $66.09

    $1.24 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 99424

    Office

    $88.96

    Facility

    $65.88

    $2.40 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 99424

    Office

    $84.39

    Facility

    $64.13

    $2.17 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 99424

    Office

    $90.81

    Facility

    $64.99

    $4.25 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 99424

    Office

    $82.29

    Facility

    $61.50

    $4.27 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 99424

    Office

    $82.74

    Facility

    $61.85

    $3.82 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 99424

    Office

    $88.40

    Facility

    $67.51

    $1.84 higher than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 99424

    Office

    $86.50

    Facility

    $65.76

    $0.06 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 99424

    Office

    $91.64

    Facility

    $68.32

    $5.08 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 99424

    Office

    $83.04

    Facility

    $61.98

    $3.52 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 99424

    Office

    $82.29

    Facility

    $61.76

    $4.27 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 99424

    Office

    $83.27

    Facility

    $63.08

    $3.29 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 99424

    Office

    $85.92

    Facility

    $64.55

    $0.64 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 99424

    Office

    $83.28

    Facility

    $63.18

    $3.28 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 99424

    Office

    $95.96

    Facility

    $68.84

    $9.40 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99424

    Office

    $89.42

    Facility

    $65.50

    $2.86 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99424

    Office

    $91.74

    Facility

    $67.37

    $5.18 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 99424

    Office

    $88.12

    Facility

    $65.13

    $1.56 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 99424

    Office

    $83.29

    Facility

    $62.39

    $3.27 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 99424

    Office

    $85.84

    Facility

    $63.33

    $0.72 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 99424

    Office

    $88.79

    Facility

    $66.87

    $2.23 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 99424

    Office

    $84.90

    Facility

    $64.17

    $1.66 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 99424

    Office

    $85.95

    Facility

    $62.58

    $0.61 lower than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 99424

    Office

    $85.27

    Facility

    $63.94

    $1.29 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 99424

    Office

    $85.82

    Facility

    $64.20

    $0.74 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 99424

    Office

    $82.53

    Facility

    $62.95

    $4.03 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 99424

    Office

    $81.63

    Facility

    $62.07

    $4.93 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 99424

    Office

    $87.50

    Facility

    $64.79

    $0.94 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 99424

    Office

    $83.81

    Facility

    $62.62

    $2.75 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 99424

    Office

    $85.33

    Facility

    $62.62

    $1.23 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 99424

    Office

    $82.50

    Facility

    $61.54

    $4.06 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 99424

    Office

    $88.50

    Facility

    $64.86

    $1.94 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 99424

    Office

    $96.48

    Facility

    $70.13

    $9.92 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 99424

    Office

    $93.06

    Facility

    $68.26

    $6.50 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 99424

    Office

    $85.31

    Facility

    $64.48

    $1.25 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 99424

    Office

    $86.93

    Facility

    $64.20

    $0.37 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99424

    Office

    $100.45

    Facility

    $73.44

    $13.89 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99424

    Office

    $93.82

    Facility

    $68.95

    $7.26 higher than Wyoming** for the office setting.

  • Queens

    New York · 99424

    Office

    $98.68

    Facility

    $71.83

    $12.12 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 99424

    Office

    $84.65

    Facility

    $63.07

    $1.91 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 99424

    Office

    $84.46

    Facility

    $63.72

    $2.10 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 99424

    Office

    $82.90

    Facility

    $62.62

    $3.66 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 99424

    Office

    $91.27

    Facility

    $66.04

    $4.71 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 99424

    Office

    $86.28

    Facility

    $63.66

    $0.28 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99424

    Office

    $90.54

    Facility

    $66.90

    $3.98 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99424

    Office

    $84.41

    Facility

    $63.55

    $2.15 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 99424

    Office

    $87.84

    Facility

    $64.88

    $1.28 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 99424

    Office

    $89.20

    Facility

    $65.74

    $2.64 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 99424

    Office

    $84.27

    Facility

    $63.28

    $2.29 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 99424

    Office

    $85.07

    Facility

    $62.36

    $1.49 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 99424

    Office

    $82.59

    Facility

    $61.94

    $3.97 lower than Wyoming** for the office setting.

  • Austin

    Texas · 99424

    Office

    $89.24

    Facility

    $65.21

    $2.68 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 99424

    Office

    $84.06

    Facility

    $63.39

    $2.50 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 99424

    Office

    $86.77

    Facility

    $64.26

    $0.21 higher than Wyoming** for the office setting.

  • Dallas

    Texas · 99424

    Office

    $87.28

    Facility

    $64.66

    $0.72 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 99424

    Office

    $86.98

    Facility

    $64.58

    $0.42 higher than Wyoming** for the office setting.

  • Galveston

    Texas · 99424

    Office

    $87.02

    Facility

    $64.46

    $0.46 higher than Wyoming** for the office setting.

  • Houston

    Texas · 99424

    Office

    $89.03

    Facility

    $66.48

    $2.47 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 99424

    Office

    $85.35

    Facility

    $63.79

    $1.21 lower than Wyoming** for the office setting.

  • Utah

    Utah · 99424

    Office

    $85.01

    Facility

    $63.66

    $1.55 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 99424

    Office

    $85.83

    Facility

    $63.50

    $0.73 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99424

    Office

    $87.84

    Facility

    $64.88

    $1.28 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 99424

    Office

    $85.34

    Facility

    $62.86

    $1.22 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 99424

    Office

    $89.14

    Facility

    $65.22

    $2.58 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 99424

    Office

    $97.30

    Facility

    $69.43

    $10.74 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 99424

    Office

    $83.48

    Facility

    $61.72

    $3.08 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 99424

    Office

    $84.46

    Facility

    $64.72

    $2.10 lower than Wyoming** for the office setting.

See how rates vary across the country

99424 · 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.

$80.74

$112.38

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$112.381
AL$81.491
AR$80.741
AZ$85.881
CA$90.03–$106.7829
CO$89.551
CT$91.981
DC$96.841
DE$86.961
FL$87.80–$94.583
GA$84.39–$88.962
GU$90.811
HI$90.811
IA$82.291
ID$82.741
IL$86.50–$92.784
IN$83.041
KS$82.291
KY$83.271
LA$83.28–$85.922
MA$89.42–$95.962
MD$88.12–$96.843
ME$83.29–$85.842
MI$84.90–$88.792
MN$85.951
MO$82.53–$85.823
MS$81.631
MT$87.501
NC$83.811
ND$85.331
NE$82.501
NH$88.501
NJ$93.06–$96.482
NM$85.311
NV$86.931
NY$84.65–$100.455
OH$84.461
OK$82.901
OR$86.28–$91.272
PA$84.41–$90.542
PR$87.841
RI$89.201
SC$84.271
SD$85.071
TN$82.591
TX$84.06–$89.248
UT$85.011
VA$85.83–$96.842
VI$87.841
VT$85.341
WA$89.14–$97.302
WI$83.481
WV$84.461
WY$86.561

Explore 99424 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 99424 in Wyoming**, the physician’s office rate is $86.56 and the facility-setting rate is $63.84: a difference of $22.72.

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 99424 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$95.22

$86.56 × 110% = $95.22

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 99424 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

13,105

Code
99424
Physician work
1.45
Practice expense
1.06
Malpractice
0.11

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 99424 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work1.45× 1.0001.4500
Practice expense1.06× 1.0001.0600
Malpractice0.11× 0.7400.0814
Total RVUs2.5914
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$86.56

Open 99424 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.451
Practice expense1.061
Malpractice0.110.74

(1.45 × 1 + 1.06 × 1 + 0.11 × 0.74) × $33.4009 = $86.56

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.451
Practice expense0.381
Malpractice0.110.74

(1.45 × 1 + 0.38 × 1 + 0.11 × 0.74) × $33.4009 = $63.84

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

99424 · Office / nonfacility

$86.56

Effective 2026-10-01

The base rate is $6.71 higher than on 2025-10-01, moving from $79.85 to $86.56 (8.4%).

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

    $79.85changed to$86.56

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.93 changed to 1.06
    • Malpractice RVU 0.12 changed to 0.11
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $79.85

    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$86.56$63.84RVU26D
2026-07-01$86.56$63.84RVU26C
2026-04-01$86.56$63.84RVU26B
2026-01-01$86.56$63.84RVU26A
2025-10-01$79.85$71.12RVU25D
2025-07-01$79.85$71.12RVU25C
2025-04-01$79.85$71.12RVU25B
2025-01-01$79.85$71.12RVU25A

99424 billing questions

What distinguishes principal care management from chronic care management?

Principal care management centers on one complex, high-risk chronic condition. Chronic care management codes such as 99491 address a different care-management service and eligibility framework.

Does 99424 include clinical staff time?

No. It represents qualifying time personally furnished by a physician or other qualified health care professional. Staff time is addressed by 99426 and 99427.

How much time supports 99424?

At least 30 minutes of qualifying physician or qualified health care professional time in the calendar month. Document the time and the principal care management work performed.

Can the code be billed once for each call or care coordination contact?

No. It is a monthly service, not a per-contact code. The documented qualifying work must reach the 30-minute threshold during the calendar month.

When is 99425 reported with 99424?

99425 is the add-on code for each additional 30 minutes of physician or qualified health care professional principal care management in the same calendar month.

What documentation supports choosing 99424?

Document the single complex chronic condition, why it presents significant risk, the disease-specific care plan and management activities, and the physician or qualified health care professional’s time.

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 99424PPRRVU2026_Oct_nonQPP.csv, line 13,105 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet