CPT 99221 Medicare Fee Schedule 2026
Medicare's 2026 national payment for CPT 99221 is $74.48 in a non-facility setting ($74.48 in a facility), down 6.4% from $79.57 in 2025.
- Non-facility
- $74.48
- Facility
- $74.48
- vs. 2025
- -6.4%
CMS code description
99221 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 | $74.48 | $74.48 | -6.4% |
| October 2025 | $79.57 | $79.57 | -2.8% |
| March 2024 | $81.89 | $81.89 | -1.8% |
| January 2023 | $83.36 | $83.36 | -17.2% |
| July 2022 | $100.70 | $100.70 | - |
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. The facility amount applies when the service is performed in a hospital or other facility setting.
See what state Medicaid programs pay for 99221
50 state Medicaid agencies publish their own physician fee schedule. The 99221 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.
Commercial payers publish their negotiated rates for 99221 in transparency files. See how those compare with Medicare's rate.
Commercial rates for 99221Compare Medicare's rate for 99221 with published commercial rates
Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.
Nearby codes
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