Billing code 99460: Newborn careMedicare rate & RVUs in Washington
Initial hospital or birthing-center evaluation and management of a normal newborn, reported for the day the clinician begins routine inpatient newborn care.
CMS doesn’t publish an office rate for 99460 in Washington.
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 99460 covers
A physician or other qualified health professional reports this service for the initial evaluation and management of a normal newborn in a hospital or birthing center. The encounter typically includes review of pregnancy and delivery information, a newborn examination, assessment of the infant’s status, and a plan for routine care. Pediatricians, neonatologists, and family physicians commonly provide this care.
Select 99460 when the clinician provides the initial normal-newborn hospital or birthing-center care for that day. The record should support the newborn’s normal status and document the assessment and care plan. The code is reported per day, rather than by time spent. Use the subsequent-day newborn service when care continues on a later hospital day, or the same-day discharge service when the initial evaluation and discharge occur on the same date.
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 99460 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $81.38 |
| Seattle (King Cnty) | Unavailable | $86.18 |
How the 99460 rate is calculated
Each of 99460’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 · 99460
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.92Practice expense 0.38Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99460
99460 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 · 99460
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
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99460 isn’t priced in this setting.
99460 compared with similar codes
Compare codes
99460 vs 99461 vs 99462 vs 99463 vs 99468: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99461Newborn care
- 99460 is for initial care in a hospital or birthing center; 99461 is for initial normal-newborn care outside those settings.
- 99462Newborn care
- Use 99460 for initial-day normal-newborn care and 99462 for subsequent-day care during the same hospitalization.
- 99463Newborn care
- 99463 applies when initial normal-newborn care and discharge take place on the same date; 99460 applies when the newborn remains in care.
- 99468Neonatal critical care
- 99460 is for a normal newborn’s routine hospital care. 99468 is for initial-day neonatal critical care when the infant is critically ill or injured.
99460 billing questions
How does 99460 differ from 99462?
99460 is for the initial normal-newborn hospital or birthing-center care on a day. 99462 is for subsequent-day care during the hospitalization.
When is 99463 used instead?
Use 99463 when the initial normal-newborn evaluation and discharge occur on the same date. 99460 is for initial care when the newborn remains under hospital or birthing-center care.
Is 99460 time based?
No. It is reported per day, not by minutes. The documentation should describe the evaluation and management provided that day.
Can 99460 be used for a newborn receiving critical care?
99460 describes care of a normal newborn. For a critically ill neonate receiving intensive care, select the applicable neonatal critical-care service, such as 99468 for initial-day care.
Does the code apply to newborn care outside a hospital or birthing center?
No. 99460 is for initial care in a hospital or birthing center. Initial normal-newborn care in another setting is represented by 99461.
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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