No office rate
Use 99464 for attendance at delivery and initial stabilization. Use 99465 when active delivery-room resuscitation, such as positive-pressure ventilation or chest compressions, is provided.
On this page
CMS RVU26D · Effective 2026-10-01
99465 Newborn resuscitation Medicare reimbursement rates in Illinois
Reports active resuscitation of a newborn in the delivery or birthing room, such as positive-pressure ventilation or chest compressions. Compare 99465 office and facility rates across CMS payment localities in Illinois.
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 99465 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$125.25–$132.15
4 of 4 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.
Where 99465 pays more and less in Illinois
Neonatal care
About 99465: Newborn delivery room resuscitation
Reports active resuscitation of a newborn in the delivery or birthing room, such as positive-pressure ventilation or chest compressions.
CPT 99465 describes active resuscitation of a newborn in the delivery or birthing room, including measures such as positive-pressure ventilation or chest compressions. A physician or other qualified clinician with responsibility for newborn resuscitation may provide the service in a hospital delivery suite or birthing room. Endotracheal intubation and medication administration may be part of the resuscitation when clinically needed.
Select this code for the resuscitation service itself, not simply for being present at delivery or providing initial stabilization. The record should identify the resuscitative measures performed and the newborn’s condition and response. Distinguish this service from routine newborn hospital care or neonatal critical care based on the service delivered and its setting. The supplied CMS facts list no special payment rule for this code; payment is valued under the physician fee schedule.
Where the value comes from
- Work RVU2.93 · 79%
- Practice expense (office) RVU0.59 · 16%
- Malpractice RVU0.18 · 5%
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.
99465 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
99460 represents initial newborn hospital care, not delivery-room resuscitation. The services may describe distinct work when both are provided and documented.
No office rate
99468 represents initial neonatal critical care, rather than resuscitation performed in the delivery or birthing room.
Compare 99465 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$132.15
East St. Louis →
Office / nonfacility
Unavailable
Facility
$128.10
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$125.25
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$129.44
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
99465 billing questions
How is 99465 different from 99464?
99465 is for active delivery-room resuscitation, such as positive-pressure ventilation or chest compressions. 99464 describes attendance at delivery and initial stabilization without that resuscitation service.
Should intubation or medication administration be coded separately?
These interventions may be part of the newborn resuscitation reported with 99465. Document what was performed as part of the resuscitation rather than treating each intervention as a separate 99465 service.
What documentation supports 99465?
Document the newborn’s condition, the resuscitative measures provided, and the response. Include details such as ventilation, chest compressions, intubation, or medication administration when performed.
Can 99465 be reported with initial newborn hospital care?
The services describe different work: 99465 covers delivery-room resuscitation, while 99460 covers initial newborn hospital care. Documentation should establish the distinct service provided for each.
Is 99465 for neonatal intensive care after delivery?
No. It describes resuscitation in the delivery or birthing room. Neonatal critical care after delivery is represented by a different service, such as 99468.
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.
13,12999462,,Sbsq nb em per day hosp,A,,0.84,0.17,NA,0.17,,0.05,1.06,1.06,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13099463,,Same day nb discharge,A,,2.13,0.58,NA,0.58,,0.13,2.84,2.84,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13199464,,Attendance at delivery,A,,1.50,0.31,NA,0.31,,0.08,1.89,1.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13299465,,Nb resuscitation,A,,2.93,0.59,NA,0.59,,0.18,3.70,3.70,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13399466,,Ped crit care transport,A,,4.79,0.97,NA,0.97,,0.28,6.04,6.04,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13499467,,Ped crit care transport addl,A,,2.40,0.48,NA,0.48,,0.15,3.03,3.03,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13599468,,Neonate crit care initial,A,,18.46,3.71,NA,3.71,,1.14,23.31,23.31,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00