No office rate
99460 reports initial hospital or birthing-center care without the same-day admission-and-discharge circumstance that defines 99463.
On this page
CMS RVU26D · Effective 2026-10-01
99463 Newborn care Medicare reimbursement rates in Washington
Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date. Compare 99463 office and facility rates across CMS payment localities in Washington.
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 99463 in Washington?
Washington 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
$95.77–$102.02
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 99463: Same-day newborn hospital care
Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date.
This service covers the same-day hospital or birthing-center care of a normal newborn, including the initial evaluation and management and the discharge-related care. It is typically performed by a physician or other qualified clinician responsible for the newborn’s care during the stay. The code is specific to a newborn admitted and discharged on the same calendar date; it is not the selection for a newborn who remains admitted for a later date.
Report one same-day episode for the infant rather than separate newborn-care entries for admission and discharge. Documentation should support the newborn’s normal status, the initial assessment and management, and the same-date admission and discharge. The CMS physician fee schedule assigns physician-work and practice-expense values to this service. Choose among newborn-care codes according to the care setting, whether the service is initial or subsequent, and whether discharge occurs that day.
Where the value comes from
- Work RVU2.13 · 75%
- Practice expense (office) RVU0.58 · 20%
- Malpractice RVU0.13 · 5%
33
Medicare services in 2024 · #5607 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.
99463 compared with similar codes
Office rates for Washington, from the same CMS release.
$96.46–$106.75
99461 is for initial newborn care outside a hospital or birthing center; 99463 is for the same-day episode in a hospital or birthing center.
No office rate
99462 applies to subsequent daily care when the newborn remains admitted. 99463 covers initial and discharge-related care when both occur on the same date.
Compare 99463 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 Washington →
Office / nonfacility
Unavailable
Facility
$95.77
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$102.02
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
99463 billing questions
When should 99463 be used instead of 99460?
Use 99463 when the normal newborn is admitted to a hospital or birthing center and discharged on the same date. Use 99460 for initial hospital or birthing-center newborn care when the same-day discharge circumstance does not apply.
Can 99463 be reported for newborn care outside a hospital or birthing center?
No. For initial care of a normal newborn in a non-facility setting, consider 99461 instead.
How does 99463 differ from 99462?
99463 represents the same-day admission and discharge episode. 99462 is for subsequent daily care of a normal newborn who remains in the hospital or birthing center.
Should admission and discharge be coded as two separate newborn-care services?
No. 99463 represents the same-day newborn-care episode, including the initial and discharge-related care.
What documentation supports 99463?
Document the newborn’s normal status, the initial evaluation and management, and the admission and discharge dates showing both occurred on the same date.
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.
13,12799460,,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
13,13399466,,Ped crit care transport,A,,4.79,0.97,NA,0.97,,0.28,6.04,6.04,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00