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CPT code 99358: Prolonged E/M, without direct contact2026 Medicare rate & RVUs in Colorado

Reports prolonged evaluation and management work performed without direct patient contact, distinct from prolonged time during a face-to-face or other direct-contact E/M service.

CMS RVU26DEffective Oct 1, 2026One payment locality

CMS doesn’t publish a rate for 99358 in Colorado.

Separate payment rules applyOffice (non-facility)
Separate payment rules applyHospital or facility

Check a contract rate as a % of Medicare · 99358 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99358 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 99358 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99358 covers

This CPT code identifies prolonged evaluation and management work performed without direct patient contact. It is distinct from prolonged time spent with the patient during an E/M encounter. Physicians and other qualified health professionals use it for extended E/M-related work connected to a patient's care. CPT 99359 is the companion add-on for additional qualifying non-face-to-face prolonged service time.

Medicare assigns 99358 status I, meaning the code is not valid for Medicare. Medicare uses a different code to report and pay for this service, so 99358 is not the Medicare reporting code. Its non-face-to-face service distinction separates 99358 from prolonged E/M codes for direct-contact services.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Colorado compares for 99358

99358 in Colorado vs other payment areas
  1. Colorado · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

Other areas in Colorado first, then benchmark localities. Bars start at $0.

Every other payment area

99358 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

99358 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99358 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 99358 in every payment locality

How the 99358 rate is calculated

Each of 99358’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99358

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.80

1.80 RVUs× 1.000 GPCI

Practice expense0.84

0.84 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

2.7500

Conversion factor

$33.4009

Medicare rate

$91.85

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 99358

99358 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99358

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

99358 isn’t priced in this setting.

Codes related to 99358

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 99358
CodeHow it relatesOffice range, Colorado
Add-on codes
99359Prolonged service, additional 30 minutesAdd-on code for additional qualifying non-face-to-face prolonged service time.No office rate
Used instead
99417Prolonged E/M, office or outpatientFor prolonged office or outpatient E/M time involving direct patient contact.No office rate
99418Prolonged E/M, inpatient or observationFor prolonged hospital or observation E/M time involving direct patient contact.No office rate

How 99358 has changed in Colorado

99358 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2023

    RVU23A

    $111.25changed toNo rate

    Held through RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. January 1, 2022

    RVU22A

    $112.07changed to$111.25

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.95 changed to 0.96
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  3. January 1, 2021

    RVU21A

    $114.33changed to$112.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.92 changed to 0.95
    • Malpractice RVU 0.13 changed to 0.15
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  4. January 1, 2020

    RVU20A

    $114.33changed to$114.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.90 changed to 0.92
    • Malpractice RVU 0.15 changed to 0.13
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  5. January 1, 2019

    RVU19A

    $114.58changed to$114.33

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.91 changed to 0.90

    Held through RVU19B, RVU19C, RVU19D.

  6. January 1, 2018

    RVU18AR1

    $114.25changed to$114.58

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  7. January 1, 2017

    RVU17A

    No ratechanged to$114.25

    Held through RVU17B, RVU17C, RVU17D.

  8. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Separate payment rules applySeparate payment rules applyRVU26D
2026-07-01Separate payment rules applySeparate payment rules applyRVU26C
2026-04-01Separate payment rules applySeparate payment rules applyRVU26B
2026-01-01Separate payment rules applySeparate payment rules applyRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01$111.25$111.25RVU22D
2022-07-01$111.25$111.25RVU22C
2022-04-01$111.25$111.25RVU22B
2022-01-01$111.25$111.25RVU22A
2021-10-01$112.07$112.07RVU21D
2021-07-01$112.07$112.07RVU21C
2021-04-01$112.07$112.07RVU21B
2021-01-01$112.07$112.07RVU21A
2020-10-01$114.33$114.33RVU20D
2020-07-01$114.33$114.33RVU20C
2020-04-01$114.33$114.33RVU20B
2020-01-01$114.33$114.33RVU20A
2019-10-01$114.33$114.33RVU19D
2019-07-01$114.33$114.33RVU19C
2019-04-01$114.33$114.33RVU19B
2019-01-01$114.33$114.33RVU19A
2018-10-01$114.58$114.58RVU18D
2018-07-01$114.58$114.58RVU18C
2018-04-01$114.58$114.58RVU18B
2018-01-01$114.58$114.58RVU18AR1
2017-10-01$114.25$114.25RVU17D
2017-07-01$114.25$114.25RVU17C
2017-04-01$114.25$114.25RVU17B
2017-01-01$114.25$114.25RVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price 99358 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

99358 billing questions

What service does 99358 represent?

It represents prolonged E/M-related work performed without direct patient contact.

How does 99358 differ from 99359?

99358 is the primary code in this non-face-to-face prolonged-service pairing. 99359 is the add-on for additional qualifying service time.

Does 99358 report prolonged time with the patient?

No. It describes prolonged work without direct patient contact, rather than prolonged time during a direct-contact E/M service.

Can 99358 be reported to Medicare?

No. Medicare assigns it status I and uses a different code to report and pay for this service.

Is 99358 the E/M visit itself?

No. It represents prolonged E/M-related work without direct patient contact, not the patient encounter.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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