CPT 99447
Global XXX ActiveNtrprof ph1/ntrnet/ehr 11-20
CPT 99447 Billing & Documentation Guide
CPT code 99447 (Ntrprof ph1/ntrnet/ehr 11-20) is classified under E/M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.7, a non-facility practice expense RVU of 0.37, and a malpractice RVU of 0.07, a total non-facility RVU of 1.14 and facility RVU of 0.96. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $38.76, though rates vary from $35.2 to $49.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 99447, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 99447 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 99447 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 99447
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.7 | 0.7 |
| Practice Expense RVU | 0.37 | 0.19 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 1.14 | 0.96 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 99447
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $40.11 | $33 | $38.58 - $45.03 | 29 |
| Florida | $40.33 | $34.3 | $38.71 - $42.16 | 3 |
| Georgia | $38 | $32.27 | $37.19 - $38.81 | 2 |
| Illinois | $39.87 | $34.06 | $38.32 - $41.33 | 4 |
| Michigan | $38.28 | $32.63 | $37.3 - $39.25 | 2 |
| North Carolina | $36.4 | $30.8 | $36.4 - $36.4 | 1 |
| New York | $41.45 | $34.75 | $36.76 - $43.91 | 5 |
| Ohio | $37.02 | $31.53 | $37.02 - $37.02 | 1 |
| Pennsylvania | $38.2 | $32.31 | $36.94 - $39.46 | 2 |
| Texas | $37.85 | $31.93 | $36.8 - $39.06 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 99447
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 99447 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0359T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0360T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0361T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0362T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0363T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0364T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0365T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0366T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0367T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0368T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 99447
What does CPT code 99447 mean? +
CPT code 99447 represents: Ntrprof ph1/ntrnet/ehr 11-20. It's in the E/M category with a global period of XXX.
What is the Medicare reimbursement for CPT 99447? +
The 2026 Medicare national average non-facility payment for CPT 99447 is $38.76. Rates range from $35.2 to $49.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 99447? +
E/M codes commonly use modifier 25 (significant separately identifiable E/M on same day as a procedure), 57 (decision for major surgery), 24 (unrelated E/M during global period), 95 (synchronous audio+video telehealth), 93 (audio-only telehealth), and AI (principal physician of record on admission). Surgical modifiers like 50, 51, 59 do not apply to E/M.
What bundling edits apply to CPT 99447? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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