No office rate
Both describe subsequent intensive care, but 99478 is for the lower infant-weight band; 99479 covers 1,500–2,500 grams.
On this page
CMS RVU26D · Effective 2026-10-01
99479 Neonatal intensive care Medicare reimbursement rates in Alabama
Report 99479 for a subsequent-day intensive-care evaluation and management service for an infant in the 1,500–2,500-gram weight band. Compare 99479 office and facility rates across CMS payment localities in Alabama.
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 99479 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$100.95
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Neonatal care
About 99479: Subsequent intensive care, 1,500–2,500 grams
Report 99479 for a subsequent-day intensive-care evaluation and management service for an infant in the 1,500–2,500-gram weight band.
99479 represents a subsequent-day intensive-care service for an infant in the 1,500–2,500-gram weight band. A neonatologist or other physician or qualified health professional manages the infant in a neonatal intensive-care setting, reassessing clinical status and directing ongoing care when the infant continues to need intensive services. It is distinct from routine newborn or nursery management and from the initial hospital-care service.
Select the code using the infant’s documented weight band and whether the service is subsequent rather than initial; 99478 and 99480 represent the adjacent lower and higher bands. Report it for the day of subsequent intensive care, not as a timed service. Documentation should support the infant’s weight, continued need for intensive care, the clinician’s assessment, and the management provided that day. CMS assigns work, practice-expense, and malpractice relative value units to this per-day service.
Where the value comes from
- Work RVU2.50 · 79%
- Practice expense (office) RVU0.50 · 16%
- Malpractice RVU0.15 · 5%
72
Medicare services in 2024 · #5131 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.
99479 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Both describe subsequent intensive care, but 99480 is for the higher infant-weight band; 99479 covers 1,500–2,500 grams.
No office rate
99477 is for initial hospital care. Use 99479 for subsequent-day intensive care when the infant falls within its weight band.
No office rate
99469 describes subsequent neonatal critical care, while 99479 is the weight-banded subsequent intensive-care service for a 1,500–2,500-gram infant.
Compare 99479 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$100.95
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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 99479 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
13,146
- Code
- 99479
- Physician work
- 2.50
- Practice expense
- 0.50
- Malpractice
- 0.15
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.50 | × 1.000 | 2.5000 |
| Practice expense | 0.50 | × 0.875 | 0.4375 |
| Malpractice | 0.15 | × 0.566 | 0.0849 |
| Total RVUs | 3.0224 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$100.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.5 | 1 |
| Practice expense | 0.5 | 0.875 |
| Malpractice | 0.15 | 0.566 |
(2.5 × 1 + 0.5 × 0.875 + 0.15 × 0.566) × $33.4009 = $100.95
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.
99479 billing questions
How does 99479 differ from 99478 and 99480?
These subsequent intensive-care codes distinguish infants by weight band. Use 99479 for the 1,500–2,500-gram band; 99478 and 99480 describe the neighboring lower and higher bands, respectively.
When is 99479 used instead of 99477?
99479 describes subsequent-day intensive care. 99477 is the initial hospital-care service for a newborn or infant requiring intensive observation, frequent interventions, and other intensive care services.
Is 99479 reported by time or by day?
It is a per-day service, not a timed code. The record should support the subsequent intensive-care management provided for that day.
What documentation supports 99479?
Document the infant’s weight, the ongoing need for intensive care, the daily clinical assessment, and the management directed by the reporting clinician.
How is 99479 distinguished from 99469?
99479 is a subsequent intensive-care service selected by infant weight band. 99469 describes subsequent neonatal critical care, a different service category for a critically ill neonate.
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.
13,14399476,,Ped crit care age 2-5 subsq,A,,6.75,1.87,NA,1.87,,0.55,9.17,9.17,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14499477,,Init day hosp neonate care,A,,7.00,1.41,NA,1.41,,0.43,8.84,8.84,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14599478,,"Sbsq ic vlbw inf<1,500 gm",A,,2.75,0.55,NA,0.55,,0.17,3.47,3.47,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14699479,,"Sbsq ic lbw inf 1,500-2,500",A,,2.50,0.50,NA,0.50,,0.15,3.15,3.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14799480,,"Sbsq ic inf pbw 2,501-5,000",A,,2.40,0.48,NA,0.48,,0.15,3.03,3.03,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14899483,,Assmt & care pln pt cog imp,A,,3.84,4.66,,0.97,,0.27,8.77,5.08,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14999484,,Care mgmt svc bhvl hlth cond,A,,0.93,0.73,,0.17,,0.06,1.72,1.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515