Medicare Physician Fee Schedule · Q3 2026 release
CPT 99204 in Long Island, NY
A moderate-complexity visit for a new patient — for example, establishing care for someone with two or more chronic conditions, or evaluating a new problem such as unexplained weight loss that needs further work-up. Total visit time typically runs about 45 to 59 minutes, and documentation should reflect a more detailed history, moderate data review, and moderate risk from the plan of care.
Medicare pays, Office (non-facility) setting, in Long Island, NY
$205.38
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Long Island, NY pays above the national baseline by 15.8%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Long Island, NY pays $133.50 for 99204.
ZIP codes in this locality
This payment locality covers 440 ZIP codes, including 00501, 00544, 06390, 10301, 10302, 10303, 10304, 10305, 10306, 10307, 10308, 10309 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.