Billing code 99449: Interprofessional consultMedicare rate & RVUs in Texas
Reports a consultant physician’s remote review, discussion, and written recommendations when requested by a treating clinician and the service takes at least 31 minutes.
Medicare pays $73.58–$77.86 for 99449 in the office in Texas, from Beaumont to Houston. 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 99449 covers
99449 captures a consultant physician’s substantial remote review and management input for a patient whose treating clinician requests specialty advice. The consultant reviews relevant records or test results, discusses findings and recommendations with the treating or requesting physician or other qualified health care professional, and sends a written report. A typical case is a primary care clinician seeking cardiology, neurology, infectious disease, or endocrinology guidance without arranging a face-to-face visit with the consultant.
Select 99449 when the consultant’s qualifying work totals at least 31 minutes; codes 99446–99448 cover shorter time bands. Document the request and clinical question, records reviewed, consult communication, recommendations and written report, and the consultant time supporting the threshold. The requesting clinician’s coordination work is distinct and may be reported with 99452 when its requirements are met. The CMS fee schedule values 99449 through work, practice-expense, and malpractice RVUs.
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.
Where 99449 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$73.58 to $77.86
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $77.26 | $63.83 |
| Beaumont | $73.58 | $62.03 |
| Brazoria | $75.42 | $62.84 |
| Dallas | $75.90 | $63.26 |
| Fort Worth | $75.70 | $63.19 |
| Galveston | $75.66 | $63.06 |
| Houston | $77.86 | $65.25 |
| Rest Of Texas | $74.47 | $62.43 |
How the 99449 rate is calculated
Each of 99449’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 · 99449
RVUs × geographic indexes × conversion factor
Work1.40
1.40 RVUs× 1.000 GPCI
Practice expense0.76
0.76 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
2.2800
Conversion factor
$33.4009
Medicare rate
$76.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99449
99449 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 · 99449
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$76.15
- Non-facility (office)
- $76.15
- Facility
- $63.46
Higher because the practice carries its own overhead.
99449 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99448Interprofessional consultation
- Use 99448 for 21–30 minutes of qualifying consultant work; 99449 begins at 31 minutes.
- 99451E-consult
- 99451 covers a related interprofessional consultation with a written report and a shorter minimum time threshold; 99449 is for 31 minutes or more and includes consultant communication and a written report.
- 99452Referral coordination
- 99452 represents the requesting clinician’s referral-preparation and communication work. 99449 represents the consultant physician’s review, advice, and report.
99449 billing questions
When should 99449 be selected instead of 99448?
Use 99449 when the consultant’s qualifying service reaches at least 31 minutes. Code 99448 is the 21–30 minute band.
Does 99449 require both a discussion and a written report?
Yes. The service includes communication of the consultant’s advice to the treating or requesting clinician and a written report.
Can the requesting clinician’s work be reported separately?
The requesting clinician’s referral preparation and communication work is separate from the consultant’s service. Code 99452 may apply when its requirements are met.
What documentation supports 99449?
Document who requested the consultation, the clinical question, records reviewed, the communication and recommendations, the written report, and the consultant’s time.
Can 99449 represent an in-person specialist evaluation?
No. It represents remote interprofessional assessment and communication, not the consultant’s face-to-face evaluation of the patient.
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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