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See a sample rate comparisonCPT 99464 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Birthing Specialist Attendant, An Additional Health Professional Trained In Neonatal Resuscitation In Attendance At A Birth At The Primary Physicians Request. This Individual Provides Initial Care And Stabilizes The Newborn.
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Delivery/Birthing Room Attendance and Resuscitation Services |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day SA |
| Complexity Level | Low |
| Medicare Fee Schedule | $63.13 national non-facility rate (2026) · View Medicare rates for 99464 |
| Medicaid Fee Schedule | $55.705 median of the 8 states in the free preview · View Medicaid rates for 99464 |
National average reimbursement for CPT 99464 by major payers:
$100.07
$93.90
$97.32
$123.70
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CPT 99464
5 of 25 sample ratesHigher to lower in this preview
Kelly Hilk
$431.00Published rateDavid Tejeda
Sutter Bay Medical Foundation
$256.98Published rateMichael Karp
Epic Management, L.P. & Beaver Medical Group, L.P.
$122.45Published rateLynn Ramirez
$74.73Published rateCasey Johnston
Mendocino Community Health Clinic Inc
$61.18Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99464 vs. Other Delivery/Birthing Room Attendance and Resuscitation Services Codes
The CPT 99464 code is part of the Evaluation and Management services used for Delivery/Birthing Room Attendance and Resuscitation Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 99464 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 99460-CPT | Low | Initial Hospital Or Birthing C, Initial Hospital Or Birthing Center Care Per Dayfor Evaluation And Management Of Normal Newborn I Nfant |
| 99461-CPT | Low | Initial Care Per Day For Eva, Initial Care Per Day For Evaluation And Management Of Normal Newborn Infant Seen In Other Than Hospital Or Birthing Center |
| 99462-CPT | Low | Newborn Exam And Care, Daily Exam Monitoring And Care Of A Newborn In An Inpatient Facility Such As A Hospital Or Birthing Center. |
| 99464-CPT | Low | Birthing Specialist Attendant, An Additional Health Professional Trained In Neonatal Resuscitation In Attendance At A Birth At The Primary Physicians Request. This Individual Provides Initial Care And Stabilizes The Newborn. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99464. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99464 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT 99464 reports attendance at a delivery, when requested by the delivering physician or other qualified health care professional, and initial stabilization of the newborn.
No. When the newborn needs resuscitation, 99465 is reported instead of 99464 for that delivery.
Medicare pays CPT 99464 under the Physician Fee Schedule. The non-facility rate applies when the service is done in an office and covers the practice's staff, supplies and equipment; the lower facility rate applies in a hospital or surgery center, which bills its own facility fee. Both are adjusted for the local cost of practice. Commercial payers negotiate their own rates, often as a percentage of Medicare, so the same code can pay very differently from one contract to the next.
This page lists the rates commercial payers have published for CPT 99464 in their Transparency in Coverage files, so you can compare payers and see where a contract falls. For government benchmarks, PayerPrice also has the Medicare fee schedule lookup and Medicaid fee schedules by state.