CPT code 99457: RPM management, first 20 minutes per month2026 Medicare rate & RVUs
Report remote physiologic monitoring treatment management after 20 minutes of monthly practitioner or clinical staff work, including live communication with the patient or caregiver.
Medicare pays $51.77 for 99457 nationally in the office and $26.39 in a hospital or facility. Local office rates run $46.88–$66.68.
Medicare rate · 99457
RPM management, first 20 minutes per month
- Work RVUs
- 0.61
- Total RVUs
- 1.55
- Global days
- XXX
National rate · 2026
$51.77
Office setting, before claim adjustments.
See every locality for 99457 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 99457 covers
This service involves reviewing remotely transmitted physiologic readings and managing the patient's care. Examples include blood pressure readings for hypertension, weight trends for heart failure, pulse oximetry for chronic lung disease, and connected glucose readings for diabetes. A physician, other qualified health care professional, or clinical staff working under the billing practitioner's direction reviews trends, discusses findings with the patient or caregiver, and considers treatment changes. Primary care and specialty practices commonly perform this work from an office or remote care-management setting.
Count qualifying management time across the calendar month. Report 99457 once when at least 20 minutes have been furnished, including at least one real-time, two-way communication with the patient or caregiver. Report add-on 99458 for each additional full 20 minutes. Records should identify the dates, time spent, personnel, readings reviewed, management actions, and interactive contact. Device supply, when supported, is reported separately from management time. CMS assigns substantially more practice expense to this service in an office than in a facility. Do not count the same minutes toward chronic care management or another timed service.
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.
Where 99457 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$46.88 to $66.68
109 of 109 payment localities
99457 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$46.88
$63.31
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $63.31 | 1 |
| AL | $47.43 | 1 |
| AR | $46.88 | 1 |
| AZ | $50.65 | 1 |
| CA | $54.38–$66.68 | 29 |
| CO | $53.65 | 1 |
| CT | $54.77 | 1 |
| DC | $58.37 | 1 |
| DE | $51.38 | 1 |
| FL | $51.12–$55.05 | 3 |
| GA | $48.78–$52.58 | 2 |
| GU | $55.33 | 1 |
| HI | $55.33 | 1 |
| IA | $48.41 | 1 |
| ID | $48.66 | 1 |
| IL | $49.91–$53.79 | 4 |
| IN | $48.89 | 1 |
| KS | $48.22 | 1 |
| KY | $48.32 | 1 |
| LA | $48.26–$50.18 | 2 |
| MA | $53.42–$58.29 | 2 |
| MD | $52.23–$58.37 | 3 |
| ME | $48.86–$51.01 | 2 |
| MI | $49.33–$51.64 | 2 |
| MN | $51.70 | 1 |
| MO | $47.59–$50.33 | 3 |
| MS | $47.24 | 1 |
| MT | $51.77 | 1 |
| NC | $49.28 | 1 |
| ND | $50.98 | 1 |
| NE | $48.63 | 1 |
| NH | $52.84 | 1 |
| NJ | $55.48–$57.96 | 2 |
| NM | $49.54 | 1 |
| NV | $51.58 | 1 |
| NY | $49.87–$59.90 | 5 |
| OH | $49.17 | 1 |
| OK | $48.26 | 1 |
| OR | $51.25–$55.09 | 2 |
| PA | $49.23–$53.63 | 2 |
| PR | $52.08 | 1 |
| RI | $53.01 | 1 |
| SC | $49.29 | 1 |
| SD | $50.88 | 1 |
| TN | $48.42 | 1 |
| TX | $48.97–$53.40 | 8 |
| UT | $49.83 | 1 |
| VA | $50.87–$58.37 | 2 |
| VI | $52.08 | 1 |
| VT | $50.81 | 1 |
| WA | $53.31–$59.37 | 2 |
| WI | $49.58 | 1 |
| WV | $48.41 | 1 |
| WY | $51.42 | 1 |
How the 99457 rate is calculated
Each of 99457’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 · 99457
RVUs × geographic indexes × conversion factor
Work0.61
0.61 RVUs× 1.000 GPCI
Practice expense0.90
0.90 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.5500
Conversion factor
$33.4009
Medicare rate
$51.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99457
99457 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 · 99457
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$51.77
- Non-facility (office)
- $51.77
- Facility
- $26.39
Higher because the practice carries its own overhead.
99457 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 99458RPM management add-onEach additional 20 minutes per month
- 99457 covers the first 20 minutes in a calendar month. Add 99458 only after another full 20 minutes of qualifying management time.
- 99454RPM device supply16-30 days of readings
- 99454 covers device supply and transmission for 16–30 days in a 30-day period; 99457 covers monthly management time and interactive communication. Both may be reported when their separate requirements are met.
- 98980RTM managementFirst 20 minutes monthly
- 98980 manages remote therapeutic monitoring, such as respiratory therapy adherence or response. 99457 manages physiologic readings, such as blood pressure, weight, or oxygen saturation.
- 99091Remote data review30 minutes per 30 days
- 99091 requires at least 30 minutes of physician or qualified health care professional data collection and interpretation and does not require interactive communication. 99457 allows clinical staff time and requires that communication; distinct work and time may support both.
99457 billing questions
Does the 20 minutes have to happen in one sitting?
No. Qualifying minutes may accumulate across the calendar month, provided they reach 20 and include at least one interactive communication.
Can clinical staff perform the time, or only the physician?
Clinical staff time may count when the work is performed under the billing practitioner's direction. Document who performed the work and the time spent.
What counts as the required interactive communication?
It is a real-time, two-way exchange with the patient or caregiver, such as a phone or video conversation about the readings and care plan. Portal messages or texts alone do not meet that requirement.
How is time beyond the first 20 minutes reported?
Report add-on 99458 with 99457 for each additional full 20 minutes of qualifying management time in the calendar month.
Can this be reported in the same month as chronic care management?
Yes, when both services meet their requirements. Do not count the same minutes toward 99457 and chronic care management.
Can remote therapeutic monitoring management be billed with it?
Do not report RPM and remote therapeutic monitoring management for the same patient during the same period. Select the family that matches the monitored data and service.
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
Show the CMS file lines behind this rate
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