Billing code 99448: Interprofessional consultationMedicare rate & RVUs in Guam
A consulting physician reviews a patient’s clinical information and gives the treating clinician verbal and written guidance after 21–30 minutes of work.
Medicare pays $58.08 for 99448 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 99448 covers
A consulting physician uses this service to assess a patient’s clinical question by reviewing records, test results, or other relevant information and discussing recommendations with the treating or requesting clinician. The consultation is between clinicians rather than a direct patient visit. Common situations include a primary care clinician seeking specialist input on a complex rash from a record review or asking a cardiologist to advise on findings in the patient’s chart.
Report 99448 when the consultant’s qualifying work totals 21–30 minutes and includes both verbal communication and a written report to the treating or requesting clinician. Documentation should identify the clinical question, information reviewed, time spent, recommendations, and how the verbal and written responses were provided. The CMS physician fee schedule assigns work and practice-expense values to this service. The documented time distinguishes this code from the shorter and longer consultation levels.
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.
99448 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $58.08 | $47.82 |
How the 99448 rate is calculated
Each of 99448’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 · 99448
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.05Practice expense 0.56Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99448
99448 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 · 99448
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$56.78
The facility rate would be $47.76 (+$9.02). In a facility, the facility bills its own costs separately.
99448 compared with similar codes
Compare codes
99448 vs 99447 vs 99449 vs 99451 vs 99452: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99447Interprofessional consult
- Use 99447 for 11–20 minutes of qualifying consultant work; 99448 covers 21–30 minutes.
- 99449Interprofessional consult
- Use 99449 when qualifying consultant work reaches 31 minutes or more; 99448 is for 21–30 minutes.
- 99451E-consult
- 99451 is the consultant-service option with a written report and a different time threshold. 99448 requires both verbal communication and a written report for 21–30 minutes.
- 99452Referral coordination
- 99452 describes the requesting clinician’s work preparing for and coordinating the referral; 99448 describes the consulting physician’s assessment and recommendations.
99448 billing questions
When should 99448 be selected instead of 99447 or 99449?
Select 99448 when the consultant’s qualifying work totals 21–30 minutes. The neighboring levels cover shorter or longer time intervals.
Does the service include communication with the treating clinician?
Yes. This level includes verbal communication and a written report to the treating or requesting clinician; document both.
Can 99448 be used for a direct visit with the patient?
It describes an interprofessional consultation in which a consulting physician provides guidance to the treating or requesting clinician, rather than a direct patient visit.
What should the record support?
Document the clinical question, records or results reviewed, total time, recommendations, and the verbal and written communication with the requesting clinician.
How does 99448 differ from 99451?
99448 is the 21–30-minute level that includes verbal and written communication. 99451 is a separate consultant-service option with a written report and a different time threshold.
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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