Billing code 99462: Newborn careMedicare rate & RVUs in Delaware
Report this service for a physician or other qualified practitioner’s routine daily evaluation and management of a newborn continuing hospital nursery care.
CMS doesn’t publish an office rate for 99462 in Delaware.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 99462 covers
This service covers a routine daily assessment and management of a newborn who remains in the hospital after the initial newborn-care day. A pediatrician, family physician, or other qualified practitioner may provide it while rounding in a well-baby nursery. The care can include assessing feeding, weight, elimination, jaundice, and general adaptation, and addressing routine concerns with the family and care team.
Select the code for a subsequent hospital day of routine newborn care, rather than the initial-care code or the code for a newborn admitted and discharged on the same date. The record should support the date of service, the newborn’s status and findings, and the assessment and management performed that day. CMS assigns work, practice-expense, and malpractice relative values to this physician service; Medicare payment is determined through the applicable fee schedule and claim processing.
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.
99462 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $35.31 |
How the 99462 rate is calculated
Each of 99462’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.
How the rate is built · 99462
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.84Practice expense 0.17Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99462
99462 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.
Place of service · 99462
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
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99462 isn’t priced in this setting.
99462 compared with similar codes
Compare codes
99462 vs 99460 vs 99463 vs 99469: national Medicare rates
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How to choose
- 99460Newborn care
- 99460 describes initial hospital newborn care. Choose 99462 for routine care on a later hospital day.
- 99463Newborn care
- 99463 applies when the newborn is admitted and discharged on the same date; 99462 describes subsequent hospital-day care.
- 99469Neonatal critical care
- 99469 is subsequent neonatal critical care for a critically ill infant. 99462 is for routine newborn care in the hospital.
99462 billing questions
When should I use this instead of 99460?
Use 99460 for the initial hospital care of a normal newborn. Use 99462 for routine newborn care on a subsequent hospital day.
How many units are reported for a hospital day?
The service is reported per day. Document the newborn’s care and management for the date billed.
Does this code describe same-day newborn admission and discharge?
No. Code 99463 is for the specific circumstance in which initial newborn care and discharge occur on the same date.
Can circumcision be reported with daily newborn care?
The daily evaluation and management are distinct from a separately performed circumcision. Report the procedure separately only when it was performed and the documentation and applicable claim edits support separate reporting.
When is a neonatal critical-care code more appropriate?
Use a neonatal critical-care service, such as 99468 or 99469, when the infant requires critical care rather than routine nursery management.
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
Show the CMS file lines behind this rate
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