No office rate
99460 describes initial hospital newborn care. Choose 99462 for routine care on a later hospital day.
On this page
CMS RVU26D · Effective 2026-10-01
99462 Newborn care Medicare reimbursement rates in Virginia
Report this service for a physician or other qualified practitioner’s routine daily evaluation and management of a newborn continuing hospital nursery care. Compare 99462 office and facility rates across CMS payment localities in Virginia.
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 99462 in Virginia?
Virginia 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
No supported rate
Facility setting
$34.82–$38.12
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.
Newborn care
About 99462: Subsequent hospital newborn care
Report this service for a physician or other qualified practitioner’s routine daily evaluation and management of a newborn continuing hospital nursery care.
This service covers a routine daily assessment and management of a newborn who remains in the hospital after the initial newborn-care day. A pediatrician, family physician, or other qualified practitioner may provide it while rounding in a well-baby nursery. The care can include assessing feeding, weight, elimination, jaundice, and general adaptation, and addressing routine concerns with the family and care team.
Select the code for a subsequent hospital day of routine newborn care, rather than the initial-care code or the code for a newborn admitted and discharged on the same date. The record should support the date of service, the newborn’s status and findings, and the assessment and management performed that day. CMS assigns work, practice-expense, and malpractice relative values to this physician service; Medicare payment is determined through the applicable fee schedule and claim processing.
Where the value comes from
- Work RVU0.84 · 79%
- Practice expense (office) RVU0.17 · 16%
- Malpractice RVU0.05 · 5%
11
Medicare services in 2024 · #6171 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.
99462 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
99463 applies when the newborn is admitted and discharged on the same date; 99462 describes subsequent hospital-day care.
No office rate
99469 is subsequent neonatal critical care for a critically ill infant. 99462 is for routine newborn care in the hospital.
Compare 99462 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$38.12
Virginia →
Office / nonfacility
Unavailable
Facility
$34.82
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99462 billing questions
When should I use this instead of 99460?
Use 99460 for the initial hospital care of a normal newborn. Use 99462 for routine newborn care on a subsequent hospital day.
How many units are reported for a hospital day?
The service is reported per day. Document the newborn’s care and management for the date billed.
Does this code describe same-day newborn admission and discharge?
No. Code 99463 is for the specific circumstance in which initial newborn care and discharge occur on the same date.
Can circumcision be reported with daily newborn care?
The daily evaluation and management are distinct from a separately performed circumcision. Report the procedure separately only when it was performed and the documentation and applicable claim edits support separate reporting.
When is a neonatal critical-care code more appropriate?
Use a neonatal critical-care service, such as 99468 or 99469, when the infant requires critical care rather than routine nursery management.
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.
13,12699459,,Pelvic examination,A,,0.00,0.52,,0.52,NA,0.00,0.52,0.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12799460,,Init nb em per day hosp,A,,1.92,0.38,NA,0.38,,0.12,2.42,2.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12899461,,Init nb em per day non-fac,A,,1.26,1.48,,0.26,,0.07,2.81,1.59,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,12999462,,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