$64.79–$68.89
Use 99426 for the initial clinical staff principal care management interval; use 99427 for additional time and report it with 99426.
On this page
CMS RVU26D · Effective 2026-10-01
99427 Principal care management Medicare reimbursement rates in Georgia
Reports each additional 30 minutes of clinical staff principal care management for a patient with a serious, complex chronic condition during a calendar month. Compare 99427 office and facility rates across CMS payment localities in Georgia.
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 99427 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$51.33–$54.98
2 of 2 localities have a supported rate.
Facility setting
$31.07–$31.90
2 of 2 localities have a supported rate.
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.
Care management
About 99427: Additional clinical staff principal care management
Reports each additional 30 minutes of clinical staff principal care management for a patient with a serious, complex chronic condition during a calendar month.
This code covers an additional 30 minutes of clinical staff work in principal care management for a patient with a single serious, complex chronic condition. The work centers on the condition-specific care plan and may include coordinating care with other clinicians, supporting medication management, and following up on changes that affect the patient’s disease. Clinical staff perform the work under a physician’s or other qualified health care professional’s direction, commonly as part of outpatient care for a condition that creates substantial risk of worsening or functional decline.
Report 99427 only after the initial clinical staff principal care management interval is represented by 99426. The record should identify the condition and care plan, describe the staff activities, and support the additional time counted during the calendar month. CMS classifies 99427 as an add-on code: it must be billed with a primary procedure and is paid within that procedure’s global period.
CMS billing rules for 99427
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.71 · 44%
- Practice expense (office) RVU0.86 · 53%
- Malpractice RVU0.05 · 3%
121.9K
Medicare services in 2024 · #510 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.
99427 compared with similar codes
Office rates for Georgia, from the same CMS release.
$59.13–$62.44
99425 represents additional principal care management time furnished by a physician or other qualified professional. 99427 represents additional clinical staff time.
$48.01–$51.25
99439 is an additional-time code for chronic care management by clinical staff. 99427 is for principal care management focused on a single serious, complex chronic condition.
Compare 99427 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$54.98
Facility
$31.90
Rest Of Georgia →
Office / nonfacility
$51.33
Facility
$31.07
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99427 billing questions
What code must be reported with 99427?
Report 99427 with 99426, which represents the initial clinical staff principal care management interval. 99427 accounts for additional staff time.
How is 99427 different from 99426?
99426 reports the initial 30 minutes of clinical staff principal care management. 99427 reports each additional 30 minutes in the same calendar month.
How does 99427 differ from 99425?
Both are additional principal care management codes, but 99427 is for clinical staff time and 99425 is for physician or other qualified health care professional time.
What documentation supports an additional unit?
Document the serious chronic condition, its care plan, the clinical staff activities performed, and the time supporting the additional interval during the calendar month.
Can 99427 be reported by itself?
No. It is an add-on code and must be billed with its primary code, 99426.
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.
13,10599424,,Prin care mgmt phys 1st 30,A,,1.45,1.06,,0.38,,0.11,2.62,1.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10699425,,Prin care mgmt phys ea addl,A,,1.00,0.77,,0.25,,0.07,1.84,1.32,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10799426,,Prin care mgmt staff 1st 30,A,,1.00,0.96,,0.25,,0.07,2.03,1.32,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10899427,,Prin care mgmt staff ea addl,A,,0.71,0.86,,0.18,,0.05,1.62,0.94,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10999429,,Unlisted preventive service,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11099437,,Chrnc care mgmt phys ea addl,A,,1.00,0.82,,0.24,,0.07,1.89,1.31,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11199439,,Chrnc care mgmt staf ea addl,A,,0.70,0.76,,0.17,,0.05,1.51,0.92,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00