Internal medicine · Connecticut

Internal medicine commercial reimbursement in Connecticut

How Connecticut internal medicine rates compare with the national market.

Internal medicine in Connecticut

25 codes · 119 sampled providers
Index vs national
116
16% above
Rank among states
15 of 51
1 = highest
Codes above national
21 of 25
median code at 115%
Providers
119
sampled

What the data shows

1

Internal medicine ranks 15th of 51 states in Connecticut with an index of 116 (100 = the specialty's national median), across 25 codes and 119 sampled providers.

2

Of the 25 internal medicine codes with enough data in Connecticut, 21 pay above the national median and 4 below; the typical code sits at 115% of the national median.

3

Largest premium over the national median: CPT 96372 (Ther/proph/diag inj sc/im) at 158%; largest discount: CPT 99212 (Office o/p est sf 10 min) at 95%.

4

Measured against Medicare, Connecticut internal medicine rates have a median of 128% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeConnecticuNationalGapProv.
96372
Ther/proph/diag inj sc/im
$38$24+58%119
90960
Esrd srv 4 visits p mo 20+
$646$453+43%118
93306
Tte w/doppler complete
$452$319+42%117
93000
Electrocardiogram complete
$35$25+41%118
20610
Drain/inj joint/bursa w/o us
$107$83+28%119

Lowest vs national

CodeConnecticuNationalGapProv.
99212
Office o/p est sf 10 min
$49$52-5%119
99213
Office o/p est low 20 min
$89$92-3%119
99215
Office o/p est hi 40 min
$183$188-3%119
99214
Office o/p est mod 30 min
$131$134-2%119
99203
Office o/p new low 30 min
$126$125+1%119

All internal medicine codes in Connecticut

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeConnecticutNationalGap% of MedicareProvidersTINsLevel
CPT 96372
Ther/proph/diag inj sc/im
$38$24+58%246%119197
CPT 90960
Esrd srv 4 visits p mo 20+
$646$453+43%173%118194
CPT 93306
Tte w/doppler complete
$452$319+42%230%117194
CPT 93000
Electrocardiogram complete
$35$25+41%230%118196
CPT 20610
Drain/inj joint/bursa w/o us
$107$83+28%155%119196
CPT 78452
Ht muscle image spect mult
$768$621+24%179%118192
CPT 45385
Colonoscopy w/lesion removal
$644$535+20%288%118193
CPT 99487
Cplx chrnc care 1st 60 min
$146$121+20%101%118192
CPT 93880
Extracranial bilat study
$339$285+19%179%118193
CPT 99349
Home/res vst est mod mdm 40
$203$174+17%154%118194
CPT 99348
Home/res vst est low mdm 30
$127$109+16%161%118194
CPT 99350
Home/res vst est high mdm 60
$287$247+16%149%118194
CPT 99457
Rpm tx mgmt 1st 20 min
$61$53+15%118%118194
CPT 99490
Chrnc care mgmt staff 1st 20
$70$61+15%106%118194
CPT 99454
Rem mntr physiol param 16-30
$87$76+14%167%118192
CPT 99495
Transj care mgmt mod f2f 14d
$225$211+7%102%118196
CPT 99496
Transj care mgmt high f2f 7d
$307$291+6%103%118196
CPT 99204
Office o/p new mod 45 min
$206$196+5%116%119197
CPT 99205
Office o/p new hi 60 min
$268$256+5%113%118195
CPT 99497
Advncd care plan 30 min
$111$108+3%128%118187
CPT 99203
Office o/p new low 30 min
$126$125+1%108%119196
CPT 99214
Office o/p est mod 30 min
$131$134-2%97%119196
CPT 99215
Office o/p est hi 40 min
$183$188-3%95%119196
CPT 99213
Office o/p est low 20 min
$89$92-3%94%119197
CPT 99212
Office o/p est sf 10 min
$49$52-5%83%119197

Frequently asked questions

How do Connecticut internal medicine rates compare with the rest of the country?

Connecticut ranks 15th of 51 states with an index of 116; 21 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Connecticut?

CPT 96372 (Ther/proph/diag inj sc/im), at 158% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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