Medicare Physician Fee Schedule · Q3 2026 release
CPT 99214 in Houston, TX
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 Houston, TX
$137.41
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Houston, TX pays above the national baseline by 1.3%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Houston, TX pays $86.67 for 99214.
ZIP codes in this locality
This payment locality covers 243 ZIP codes, including 77001, 77002, 77003, 77004, 77005, 77006, 77007, 77008, 77009, 77010, 77011, 77012 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.