Last updated: March 2026CMS official rates · Free to use
Medicare Fee Schedule Lookup
Find 2026 Medicare reimbursement rates and national payment amounts for any CPT, HCPCS, or MS-DRG code. Physician Fee Schedule, Drug ASP, MS-DRG weights, Anesthesia, and Clinical Lab — sourced directly from CMS.
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Physician Fee Schedule·99427·National·2025, 2026
Current non-facility rate
$54.11▲0.0%
Facility: $31.40
Recent trend
Code description
Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure)
| Code | Date | State | Locality | Carrier | Non-Facility Fee | Facility Fee | Description |
|---|---|---|---|---|---|---|---|
| 99427 | 4/2026 | N/A | 00 | 00000 | $54.11 | $31.40 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
| 99427 | 1/2026 | N/A | 00 | 00000 | $54.11 | $31.40 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
| 99427 | 10/2025 | N/A | 00 | 00000 | $50.46 | $34.29 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
| 99427 | 7/2025 | N/A | 00 | 00000 | $50.46 | $34.29 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
| 99427 | 4/2025 | N/A | 00 | 00000 | $50.46 | $34.29 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
| 99427 | 1/2025 | N/A | 00 | 00000 | $50.46 | $34.29 | Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure) |
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$30.7399424Principal Care Management Services, For A Single High-Risk Disease, With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months, And That Places The Patient At Significant Risk Of Hospitalization, Acute Exacerbation/Decompensation, Functional Decline, Or Death, The Condition Requires Development, Monitoring, Or Revision Of Disease-Specific Care Plan, The Condition Requires Frequent Adjustments In The Medication Regimen And/Or The Management Of The Condition Is Unusually Complex Due To Comorbidities, Ongoing Communication And Care Coordination Between Relevant Practitioners Furnishing Care; First 30 Minutes Provided Personally By A Physician Or Other Qualified Health Care Professional, Per Calendar Month.
$87.51Methodology
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