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See a sample rate comparisonCPT 99486 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.
Suprv Interfac Trnsport Addl, Supervision By A Control Physician Of Interfacility Transport Care Of The Critically Ill Or Critically Injured Pediatric Patient 24 Months Of Age Or Younger Includes Two Way Communication With Transport Team Before Transport At The Referring Facility And During The Transport Including Data Interpretation And Report Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99486 |
| Medicaid Fee Schedule | $53.85 median of the 8 states in the free preview · View Medicaid rates for 99486 |
National average reimbursement for CPT 99486 by major payers:
$88.23
$84.34
$71.32
$111.99
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CPT 99486
5 of 25 sample ratesHigher to lower in this preview
Juniper Burch
Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc
$211.60Published rateMatthew Benz
Reliant Medical Group, Inc.
$131.17Published rateSoukaina Adolphe
Child Health Foundation Of Boston Inc
$92.76Published rateKaty Supportive Medicine, P.A.
Katy Supportive Medicine PA
$68.65Published rateMansoora Sheikh
Mansoora A Sheikh Md PA
$55.13Published rate
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See a sample payer proposalCPT 99486 vs. Other Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services Codes
The CPT 99486 code is part of the Evaluation and Management services used for Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care 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 99486 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 |
|---|---|---|
| 99466-CPT | Moderate | Critical Care In Ambulance, Physician Services Delivered To A Critically Ill Or Injured Toddler During A Transfer From One Facility To Another. Physician Time Varies According To Travel Time As Well As The Childs Condition And Treatment Needs. |
| 99467-CPT | Low | Ped Crit Care Transport Addl, Critical Care Face To Face Services During An Interfacility Transport Of Critically Ill Or Critically Injured Pediatric Patient 24 Months Of Age Or Younger Each Additional 30 Minutes List Separately In Addition To Code For Primary Service |
| 99485-CPT | Low | Suprv Interfacilty Transport, Supervision By A Control Physician Of Interfacility Transport Care Of The Critically Ill Or Critically Injured Pediatric Patient 24 Months Of Age Or Younger Includes Two Way Communication With Transport Team Before Transport At The Referring Facility And During The Transport Including Data Interpretation And Report First 30 Minutes |
| 99486-CPT | Low | Suprv Interfac Trnsport Addl, Supervision By A Control Physician Of Interfacility Transport Care Of The Critically Ill Or Critically Injured Pediatric Patient 24 Months Of Age Or Younger Includes Two Way Communication With Transport Team Before Transport At The Referring Facility And During The Transport Including Data Interpretation And Report Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99486. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99486 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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