localis

Describe a service in plain words, or type a CPT/HCPCS code.

Medicare fee schedule by locality · Q4 2026 release

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Texas Medicare fee schedule localities

Texas has 8 Medicare payment localities, each with its own GPCIs. For 99213 in the Office (non-facility) setting, the Q4 2026 standard non-QP amount ranges from $90.59 to $97.77. National amounts use GPCI 1.000.

Localities in Texas Copy link

Office (non-facility) amount for 99213, used as an example code, applying each locality's GPCIs with the Q4 2026 standard non-QP conversion factor (before sequestration), and its difference from the national baseline of $95.19.

Locality 99213 amount
Austin $97.77 +2.7%
Beaumont $90.59 -4.8%
Brazoria $94.44 -0.8%
Dallas $94.96 -0.2%
Fort Worth $94.51 -0.7%
Galveston $94.68 -0.5%
Houston $96.33 +1.2%
Rest of Texas $92.41 -2.9%

Need another code or the facility amount? Use the rate calculator and choose a locality from the list above.

Common questions Copy link

How many Medicare payment localities are in Texas?
Texas has 8 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.
Do Medicare rates vary within Texas?
Yes. Texas's 8 localities have different GPCIs—the work GPCI ranges from 1.000 to 1.009. The same nationally priced code can therefore pay a different amount depending on where in the state it's billed.

Source & method Copy link

We compute GPCIs and example rates from the CMS Medicare Physician Fee Schedule Q4 2026 release. Example amounts apply each locality's GPCIs to nationally priced Office (non-facility) RVUs, before the ~2% sequestration cut. Past releases are never edited, so a rate for an earlier quarter always matches what CMS published for it.

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