$21.11–$22.48
99415 represents the initial prolonged clinical staff service. Use 99416 for additional prolonged staff time, not as a substitute for the initial code.
On this page
CMS RVU26D · Effective 2026-10-01
99416 Prolonged staff service Medicare reimbursement rates in Michigan
Report 99416 for additional prolonged clinical staff time furnished under physician or qualified health care professional supervision with a qualifying office or outpatient E/M service. Compare 99416 office and facility rates across CMS payment localities in Michigan.
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 99416 in Michigan?
Michigan 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
$11.66–$12.49
2 of 2 localities have a supported rate.
Facility setting
No 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.
Prolonged services
About 99416: Additional prolonged clinical staff time
Report 99416 for additional prolonged clinical staff time furnished under physician or qualified health care professional supervision with a qualifying office or outpatient E/M service.
99416 represents additional time spent by clinical staff extending an office or outpatient evaluation and management service. It is used after the initial prolonged clinical staff service represented by 99415, when staff continue care under a physician’s or other qualified health care professional’s supervision. The work may occur in an office or outpatient setting; the claim must connect the staff time to the qualifying E/M encounter rather than to unrelated administrative work.
Report 99416 only with its required primary service, including 99415 for the initial prolonged staff service. Document the staff members involved, the supervised clinical work, and the additional time attributable to the encounter so the units billed are supported. CMS classifies this code as technical-component-only, with interpretation covered by a separate code. Payment is made within the primary procedure’s global period, so the add-on is not billed as a standalone service.
CMS billing rules for 99416
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.37 · 97%
- Malpractice RVU0.01 · 3%
1.1K
Medicare services in 2024 · #2884 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.
99416 compared with similar codes
Office rates for Michigan, from the same CMS release.
99417
No office rateProlng op e/m each 15 min
99417 represents prolonged office or outpatient E/M time furnished by the physician or other qualified health care professional; 99416 represents additional time furnished by clinical staff.
99418
No office rateProlng ip/obs e/m ea 15 min
99418 applies to prolonged inpatient or observation E/M time. 99416 is for additional prolonged clinical staff service associated with an office or outpatient E/M encounter.
Compare 99416 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
Detroit →
Office / nonfacility
$12.49
Facility
Unavailable
Rest Of Michigan →
Office / nonfacility
$11.66
Facility
Unavailable
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99416 billing questions
When should 99416 be used instead of 99415?
99415 represents the initial prolonged clinical staff service; 99416 represents additional prolonged staff time. Report 99416 only after the initial service is supported and with the required primary code.
Can 99416 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure, typically 99415 for the initial prolonged clinical staff service.
What time should the record support?
Document the additional clinical staff time spent on the encounter, the work performed, and the supervising physician or qualified health care professional. The documentation should support each unit reported.
Is 99416 a physician professional service?
CMS classifies 99416 as technical-component-only and indicates that interpretation is covered separately. The record for this code should establish the clinical staff service and its supervision.
How does 99416 differ from 99417?
99416 represents additional prolonged time furnished by clinical staff. 99417 represents prolonged office or outpatient E/M time furnished by the physician or other qualified health care professional.
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.
13,09699411,,Preventive counseling group,N,+,0.15,0.45,,0.03,,0.01,0.61,0.19,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09799412,,Preventive counseling group,N,+,0.25,0.49,,0.06,,0.02,0.76,0.33,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09899415,,Prolng clin staff svc 1st hr,A,,0.00,0.68,,0.68,NA,0.01,0.69,0.69,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,09999416,,Prolng clin staff svc ea add,A,,0.00,0.37,,0.37,NA,0.01,0.38,0.38,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10099417,,Prolng op e/m each 15 min,I,+,0.61,0.31,,0.14,,0.04,0.96,0.79,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10199418,,Prolng ip/obs e/m ea 15 min,I,+,0.81,0.18,NA,0.18,,0.05,1.04,1.04,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10299421,,Ol dig e/m svc 5-10 min,A,,0.25,0.20,,0.06,,0.02,0.47,0.33,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00