CPT 99449
Global XXX ActiveNtrprof ph1/ntrnet/ehr 31/>
CPT 99449 Billing & Documentation Guide
CPT code 99449 (Ntrprof ph1/ntrnet/ehr 31/>) is classified under E/M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.4, a non-facility practice expense RVU of 0.76, and a malpractice RVU of 0.12, a total non-facility RVU of 2.28 and facility RVU of 1.9. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $77.64, though rates vary from $70.63 to $99.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 99449, 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 99449 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 99449 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 99449
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.4 | 1.4 |
| Practice Expense RVU | 0.76 | 0.38 |
| Malpractice RVU | 0.12 | 0.12 |
| Total RVU | 2.28 | 1.9 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 99449
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 | $80.65 | $65.63 | $77.53 - $90.66 | 29 |
| Florida | $80.03 | $67.3 | $77.05 - $83.32 | 3 |
| Georgia | $75.85 | $63.74 | $74.18 - $77.51 | 2 |
| Illinois | $79.11 | $66.85 | $76.2 - $81.8 | 4 |
| Michigan | $76.24 | $64.32 | $74.46 - $78.02 | 2 |
| North Carolina | $73.01 | $61.16 | $73.01 - $73.01 | 1 |
| New York | $82.75 | $68.59 | $73.69 - $87.38 | 5 |
| Ohio | $73.98 | $62.39 | $73.98 - $73.98 | 1 |
| Pennsylvania | $76.33 | $63.9 | $73.85 - $78.81 | 2 |
| Texas | $75.73 | $63.24 | $73.58 - $77.86 | 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 99449
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 99449 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 99449
What does CPT code 99449 mean? +
CPT code 99449 represents: Ntrprof ph1/ntrnet/ehr 31/>. It's in the E/M category with a global period of XXX.
What is the Medicare reimbursement for CPT 99449? +
The 2026 Medicare national average non-facility payment for CPT 99449 is $77.64. Rates range from $70.63 to $99.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 99449? +
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 99449? +
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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