CMS October 2026Physician Fee Schedule · Free lookup

CPT 99232 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 99232 is $70.48 in a non-facility setting ($70.48 in a facility), down 7.7% from $76.34 in 2025.

National rate, October 2026

Non-facility: $70.48
Facility: $70.48
vs. 2025: -7.7%
Commercial national avg.: $93.37

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HCPCS Codes

99232

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Year

20262025

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Physician Fee Schedule·99232·National·2026, 2025

Current non-facility rate

$70.48▲0.0%

Facility: $70.48

Recent trend

Code description

Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded

Code	Date	State	Non-Facility Fee	Facility Fee	Description
99232	10/2026	N/A	$70.48	$70.48	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	7/2026	N/A	$70.48	$70.48	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	4/2026	N/A	$70.48	$70.48	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	1/2026	N/A	$70.48	$70.48	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	10/2025	N/A	$76.34	$76.34	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	7/2025	N/A	$76.34	$76.34	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	4/2025	N/A	$76.34	$76.34	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded
99232	1/2025	N/A	$76.34	$76.34	Sbsq Hosp Ip Obs Moderate 35, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Moderate Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 35 Minutes Must Be Met Or Exceeded

99232 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS file	Non-facility	Facility	Change
October 2026	$70.48	$70.48	-7.7%
October 2025	$76.34	$76.34	-2.0%
March 2024	$77.89	$77.89	-1.8%
January 2023	$79.30	$79.30	+11.2%
July 2022	$71.29	$71.29	-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

99232: Medicare vs. commercial national average

The commercial national average for 99232, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $93.37, 132% of Medicare's $70.48.

BCBS $89.94
UnitedHealthcare $83.26
Aetna $87.19
Cigna $113.09

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 99232 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

See commercial rates in your market Commercial rates for 99232

Nearby codes

99222 Medicare rate 99223 Medicare rate 99231 Medicare rate 99233 Medicare rate 99238 Medicare rate 99239 Medicare rate

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Medicaid comparison

See what state Medicaid programs pay for 99232

50 state Medicaid agencies publish their own physician fee schedule. The 99232 page shows real published rates for several of them free, with effective dates and official sources.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.

See Medicaid rates for 99232

$44.09

99233Sbsq Hosp Ip Obs High 50, Subsequent Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And High Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 50 Minutes Must Be Met Or Exceeded

$106.88

992211st Hosp Ip Obs Sf Low 40, Initial Hospital Inpatient Or Observation Care Per Day For The Evaluation And Management Of A Patient Which Requires A Medically Appropriate History And Or Examination And Straightforward Or Low Level Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 40 Minutes Must Be Met Or Exceeded

$74.48

Methodology

Rates are sourced directly from CMS Physician Fee Schedule files, indexed quarterly. Non-facility and facility prices are calculated using the published GPCI for each locality and the year's conversion factor.

View CMS Physician Fee Schedule