$18.05–$18.49
99452 is reported by the treating or requesting clinician for referral coordination. 99446 is a consultant-side service with its own time criteria.
On this page
CMS RVU26D · Effective 2026-10-01
99452 Referral coordination Medicare reimbursement rates in Maine
Reports 30 minutes of referral work by the treating clinician, including preparing records and coordinating an interprofessional consultation with another clinician. Compare 99452 office and facility rates across CMS payment localities in Maine.
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 99452 in Maine?
Maine 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
$35.48–$36.35
2 of 2 localities have a supported rate.
Facility setting
$29.95–$30.39
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.
Interprofessional consultation
About 99452: Interprofessional referral coordination, 30 minutes
Reports 30 minutes of referral work by the treating clinician, including preparing records and coordinating an interprofessional consultation with another clinician.
99452 represents the treating or requesting physician’s or qualified health care professional’s work to arrange an interprofessional consultation. That work can include reviewing and preparing the patient’s records, sending the clinical question and relevant information to a consultant, and coordinating the referral. It is used when the clinicians communicate through telephone, internet, or the electronic health record rather than conducting a joint face-to-face visit. The requesting clinician reports their own referral work; the consultant’s assessment and response are a separate service.
Report 99452 when the requesting clinician’s documented work reaches 30 minutes. Record the consultation request, the records and clinical information provided, communication or coordination performed, and total time. CMS assigns the service work and practice-expense values, with different practice-expense inputs for office and facility settings. The related consultant-side codes are selected according to the consultant’s service and time, not the requesting clinician’s referral time.
Where the value comes from
- Work RVU0.70 · 63%
- Practice expense (office) RVU0.36 · 32%
- Malpractice RVU0.05 · 5%
40.1K
Medicare services in 2024 · #870 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.
99452 compared with similar codes
Office rates for Maine, from the same CMS release.
$33.95–$34.70
Use 99452 for the requester’s 30 minutes of referral work; 99451 describes the consultant’s assessment and response.
$72.61–$74.45
99449 reports the consultant’s service at its applicable time level. 99452 reports the requesting clinician’s referral and coordination work.
Compare 99452 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
Rest Of Maine →
Office / nonfacility
$35.48
Facility
$29.95
Southern Maine →
Office / nonfacility
$36.35
Facility
$30.39
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99452 billing questions
Who reports 99452?
The treating or requesting physician or qualified health care professional reports it for their referral and coordination work. The consulting clinician reports a consultant-side code for their own work when appropriate.
How much time is required?
The requesting clinician must document 30 minutes of referral-service work. Count the clinician’s own work preparing and coordinating the consultation, not the consultant’s time.
Can 99452 be reported with 99446 or 99451?
They represent different clinicians’ work: 99452 is for the requester, while 99446–99449 and 99451 describe consultant-side services. When both clinicians perform and document their respective services, each selects the code matching their role and service.
Is 99452 the right code for the consultant’s report?
No. The requesting clinician uses 99452 for referral coordination; the consultant uses 99446–99449 or 99451 for the consultant’s assessment and response, as applicable.
What documentation supports 99452?
Document the clinical question, the information sent to the consultant, the requesting clinician’s referral and coordination activities, and the 30 minutes of work.
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.
13,11699449,,Ntrprof ph1/ntrnet/ehr 31/>,A,,1.40,0.76,,0.38,,0.12,2.28,1.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11799450,,Basic life disability exam,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
13,11899451,,Ntrprof ph1/ntrnet/ehr 5/>,A,,0.70,0.31,,0.15,,0.05,1.06,0.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,11999452,,Ntrprof ph1/ntrnet/ehr rfrl,A,,0.70,0.36,,0.18,,0.05,1.11,0.93,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12099453,,Rem mntr physiol param setup,A,,0.00,0.63,,0.63,NA,0.02,0.65,0.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12199454,,Rem mntr physiol param 16-30,A,,0.00,1.55,,1.55,NA,0.01,1.56,1.56,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12299455,,Work related disability exam,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00