CPT code 99458: RPM management add-on, each additional 20 minutes per month2026 Medicare rate & RVUs in California
Report this add-on for each additional full 20 minutes of remote physiologic monitoring treatment management in a calendar month beyond the first 20 minutes reported with 99457.
Medicare pays $43.04–$51.75 for 99458 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
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 9 sections
What 99458 covers
This service covers extended management time when a physician, other qualified health care professional, or clinical staff reviews readings from a remote physiologic monitoring device and acts on them. Typical devices include blood pressure cuffs, weight scales, glucometers, and pulse oximeters used by patients with hypertension, heart failure, diabetes, or COPD. The work can include reviewing transmitted readings, coordinating care-plan changes, and communicating with the patient or caregiver. Primary care, cardiology, and endocrinology practices commonly provide this service, including through clinical staff working under general supervision.
Management time accumulates across the calendar month. The first 20 minutes, including at least one real-time interactive communication, are reported with 99457. Each additional full 20 minutes supports one unit of 99458: a month with 60 total minutes supports 99457 plus two units of 99458. Remaining time short of another 20 minutes does not support another unit. Documentation should identify dates, minutes, personnel, and management activities. As an add-on code, 99458 is reported with its primary code, 99457, rather than alone, and CMS pays it within the primary service's global period.
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 99458 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$43.04 to $51.75
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $43.17 | $26.70 |
| Chico, CA | $43.04 | $26.56 |
| El Centro, CA | $43.04 | $26.57 |
| Fresno, CA | $43.04 | $26.56 |
| Hanford, CA | $43.04 | $26.56 |
| Los Angeles, CA | $45.41 | $27.63 |
| Madera, CA | $43.04 | $26.56 |
| Marin County, CA | $50.71 | $29.52 |
| Merced, CA | $43.04 | $26.56 |
| Modesto, CA | $43.04 | $26.56 |
| Napa, CA | $48.31 | $28.50 |
| Oxnard, CA | $45.07 | $27.30 |
| Redding, CA | $43.04 | $26.56 |
| Rest of California | $43.04 | $26.56 |
| Riverside, CA | $43.48 | $27.01 |
| Sacramento, CA | $44.74 | $27.26 |
| Salinas, CA | $44.56 | $27.14 |
| San Benito County, CA | $51.75 | $30.07 |
| San Diego, CA | $45.28 | $27.30 |
| San Francisco, CA | $50.66 | $29.47 |
| San Luis Obispo, CA | $43.88 | $26.76 |
| Santa Clara County, CA | $51.56 | $29.89 |
| Santa Cruz, CA | $45.46 | $27.20 |
| Santa Maria, CA | $44.64 | $27.11 |
| Santa Rosa, CA | $45.90 | $27.44 |
| Stockton, CA | $43.04 | $26.56 |
| Vallejo, CA | $48.24 | $28.43 |
| Visalia, CA | $43.04 | $26.56 |
| Yuba City, CA | $43.04 | $26.56 |
How the 99458 rate is calculated
Each of 99458’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 · 99458
RVUs × geographic indexes × conversion factor
Work0.61
0.61 RVUs× 1.000 GPCI
Practice expense0.59
0.59 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.2400
Conversion factor
$33.4009
Medicare rate
$41.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99458
The CMS indicators that decide how 99458 is paid alongside other services.
CMS payment indicators · 99458
RPM management add-on, each additional 20 minutes per month
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
99458 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 99457RPM managementFirst 20 minutes per month
- 99457 covers the first 20 minutes of monthly RPM management, including interactive communication. Report 99458 with it only for each further full 20 minutes.
- 99470RPM managementFirst 10 minutes
- 99470 covers the initial 10 minutes when monthly RPM management does not reach 20 minutes. It does not replace 99457 as the primary code for 99458.
- 98981RTM managementEach additional 20 minutes
- 98981 is the add-on for remote therapeutic monitoring management, such as monitoring therapy adherence or response. Use 99458 for additional management time involving physiologic readings.
- 99454RPM device supply16-30 days of readings
- 99454 covers the RPM device supply and transmission of readings for a qualifying monitoring period; 99458 covers additional treatment management time.
99458 billing questions
Can 99458 be billed without 99457?
No. It is an add-on that requires 99457 for the same patient and calendar month, after the first 20 minutes of management time are complete.
How many units of 99458 can be reported in a month?
Report one unit for each additional full 20 minutes of management time beyond the first 20 minutes. A total of 40 minutes supports one unit; 60 minutes supports two.
Do partial minutes count toward another unit?
No. A unit requires a full additional 20 minutes; for example, 55 total minutes supports 99457 plus one unit of 99458.
Can clinical staff time count toward 99458?
Yes. Medicare allows documented management time by clinical staff under general supervision of the billing practitioner.
Can the same minutes count toward chronic care management and 99458?
No. RPM and chronic care management may be reported in the same month, but each minute can be counted toward only one service.
Does management time reset each calendar month?
Yes. Tally management time separately for each calendar month to determine whether 99457 and any units of 99458 are supported.
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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