Medicare Physician Fee Schedule · Q3 2026 release
CPT 99214 in Long Island, NY
A more involved established-patient visit — for example, managing multiple chronic conditions that are not fully controlled (such as diabetes needing a medication change), or a new problem with an uncertain diagnosis that requires prescription drug management. Total visit time typically runs about 30 to 39 minutes. Documentation needs to support a higher level of decision-making: more than one chronic illness with exacerbation, or moderate risk from the treatment plan, such as starting or adjusting a prescription drug.
Medicare pays, Office (non-facility) setting, in Long Island, NY
$156.34
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Long Island, NY pays above the national baseline by 15.3%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Long Island, NY pays $95.58 for 99214.
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.