Office Visit (New, High) Cost in Kansas
Office o/p new hi 60 min
Kansas Medicare physician rate (2026)
-6.9% vs nationalSingle statewide locality.
Your ZIP in Kansas
Enter a ZIP code for your part of Kansas, from Overland Park and the Kansas City suburbs to Wichita, Topeka, Lawrence, Salina, and the western High Plains.
What this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Kansas the office and hospital physician lines for this CPT differ by $69.14.
National vs Kansas
Where Kansas ranks for this CPT
Office Visit (New, High) and how Kansas is priced
A single locality covers all of Kansas, with geographic indices in the lower national tier, so the published Medicare rates apply evenly from the Kansas City suburbs to the far western High Plains. Notably, the Kansas side of the Kansas City metro prices under the statewide Kansas locality while the Missouri side has its own metro locality, meaning the two halves of one city carry different approved amounts. Beyond that quirk, Kansas pricing is straightforwardly uniform. Wichita, Topeka, and rural Kansas all share the same adjustments.
The Kansas City metro and Wichita hold most of the state's specialists, with the academic medical center on the Kansas side of the metro serving as the top referral point. Western Kansas is genuinely frontier in places, with long distances to any hospital that performs advanced procedures, and some High Plains residents cross into Colorado or Nebraska for care. Critical access hospitals carry much of the rural load.
This procedure: This is the highest-level new-patient office visit, reserved for genuinely complex first encounters: multiple serious conditions, a diagnosis that could threaten life or function, or decisions about major interventions. Billed by time, it means 60 to 74 minutes with the clinician on the visit date. Typical examples include a first oncology consultation, a complicated multi-system workup, or a new patient with several unstable chronic diseases.
What Is Office Visit (New, High)?
This is the highest-level new-patient office visit, reserved for genuinely complex first encounters: multiple serious conditions, a diagnosis that could threaten life or function, or decisions about major interventions. Billed by time, it means 60 to 74 minutes with the clinician on the visit date. Typical examples include a first oncology consultation, a complicated multi-system workup, or a new patient with several unstable chronic diseases.
What Affects the Cost
- It is the most expensive standard office visit code, and practices reserve it for their longest, most involved new consultations.
- The specialists who bill it most, oncologists, rheumatologists, complex-care internists, tend to practice in hospital systems where facility fees compound the professional charge.
- Visits this complex almost always launch expensive diagnostics: advanced imaging, biopsies, or specialty labs, each billed separately.
- Prolonged-service add-on codes attach beyond 74 minutes, extending the charge further.
- Second-opinion consultations at academic centers often bill at this level with academic-center pricing.
Questions to Ask Before Booking
- 1.What is the charge for this highest-level consultation, including any facility fee?
- 2.Does my plan need a referral on file before this visit?
- 3.Which of the tests and treatments you are recommending need prior authorization?
- 4.Is every provider involved in my workup, radiology, pathology, labs, in my network?
- 5.If this is a second opinion, does my plan have a program that covers it in full?
Other featured procedures in Kansas
Office Visit (New, High) in other states
Office Visit (New, High) in Kansas: questions
How much does office visit (new, high) cost in Kansas?
Kansas is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99205 is $220.49 in an office and $151.35 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Does the rate change inside Kansas?
Not on the physician fee schedule. Kansas uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
What will a Medicare patient owe for the physician fee?
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $44 for the office physician line or $30 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.
Is this the full office visit (new, high) bill in Kansas?
No. $220.49 is the Medicare physician allowed amount for CPT 99205. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kansas ranks #5 of 51 states on this physician line (7% below the national office rate of $236.81).