CPT 99252
Status I Not valid for Medicare purposes. Medicare uses another code for this service. Full definition →No national payment amount
Status I is not separately payable under the PFS.
Not valid for Medicare purposes. Medicare uses another code for this service.
Common questions
Why is there no payment amount for 99252?
Its status indicator is I (not valid). Not valid for Medicare purposes. Medicare uses another code for this service. The blank is deliberate: the amount is unknown or paid another way, not zero.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October). Each release is versioned here, so past quarters stay lookupable — see what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Saw this code on your bill?
What is a 99252 visit in patient-friendly terms?
CPT 99252 is a billing code clinicians use to identify a specific service or procedure on a claim or explanation of benefits (EOB). We don't have a plain-language description on file for this exact code yet — ask your provider's billing office what service it represents, or bring it up at your next visit.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A value of blank means CMS publishes no national number for that part — which is not the same as zero.
Rate history by release
National non-facility amount for 99252 across quarterly releases. Up 3.3% since Q1 2025 · high $70.14 in Q1 2026
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 | I | $70.14 (0.0%) | $70.14 (0.0%) |
| Q2 2026 Mar 10, 2026 | I | $70.14 (0.0%) | $70.14 (0.0%) |
| Q1 2026 Dec 29, 2025 | I | $70.14 (+3.3%) | $70.14 (+3.3%) |
| Q4 2025 Sep 11, 2025 | I | $67.93 (0.0%) | $67.93 (0.0%) |
| Q3 2025 Jun 5, 2025 | I | $67.93 (0.0%) | $67.93 (0.0%) |
| Q2 2025 Jun 5, 2025 | I | $67.93 (0.0%) | $67.93 (0.0%) |
| Q1 2025 Dec 23, 2024 | I | $67.93 | $67.93 |
Billing together (NCCI edits)
NCCI Q3 2026Per CMS's National Correct Coding Initiative. Hover a code for when it's used.
Never billable with 99252 on the same date of service