Billing code 99463: Newborn careMedicare rate & RVUs in Delaware
Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date.
CMS doesn’t publish an office rate for 99463 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 99463 covers
This service covers the same-day hospital or birthing-center care of a normal newborn, including the initial evaluation and management and the discharge-related care. It is typically performed by a physician or other qualified clinician responsible for the newborn’s care during the stay. The code is specific to a newborn admitted and discharged on the same calendar date; it is not the selection for a newborn who remains admitted for a later date.
Report one same-day episode for the infant rather than separate newborn-care entries for admission and discharge. Documentation should support the newborn’s normal status, the initial assessment and management, and the same-date admission and discharge. The CMS physician fee schedule assigns physician-work and practice-expense values to this service. Choose among newborn-care codes according to the care setting, whether the service is initial or subsequent, and whether discharge occurs that day.
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.
99463 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $94.54 |
How the 99463 rate is calculated
Each of 99463’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 · 99463
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.13Practice expense 0.58Malpractice 0.13
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99463
99463 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 · 99463
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
—
99463 isn’t priced in this setting.
99463 compared with similar codes
Compare codes
99463 vs 99460 vs 99461 vs 99462: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99460Newborn care
- 99460 reports initial hospital or birthing-center care without the same-day admission-and-discharge circumstance that defines 99463.
- 99461Newborn care
- 99461 is for initial newborn care outside a hospital or birthing center; 99463 is for the same-day episode in a hospital or birthing center.
- 99462Newborn care
- 99462 applies to subsequent daily care when the newborn remains admitted. 99463 covers initial and discharge-related care when both occur on the same date.
99463 billing questions
When should 99463 be used instead of 99460?
Use 99463 when the normal newborn is admitted to a hospital or birthing center and discharged on the same date. Use 99460 for initial hospital or birthing-center newborn care when the same-day discharge circumstance does not apply.
Can 99463 be reported for newborn care outside a hospital or birthing center?
No. For initial care of a normal newborn in a non-facility setting, consider 99461 instead.
How does 99463 differ from 99462?
99463 represents the same-day admission and discharge episode. 99462 is for subsequent daily care of a normal newborn who remains in the hospital or birthing center.
Should admission and discharge be coded as two separate newborn-care services?
No. 99463 represents the same-day newborn-care episode, including the initial and discharge-related care.
What documentation supports 99463?
Document the newborn’s normal status, the initial evaluation and management, and the admission and discharge dates showing both occurred on the same date.
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
Fee sheets
Put 99463 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →