CPT code 99458: RPM management add-on, each additional 20 minutes per month2026 Medicare rate & RVUs in North Dakota
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.
In North Dakota, Medicare pays $40.62 for 99458 in the office and $25.59 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99458 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How North Dakota compares for 99458
Across 109 of 109 payment localities, the office rate for 99458 runs from $37.99 in Arkansas to $52.29 in Alaska. North Dakota pays $40.62. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$40.62
- Los Angeles, CA · California$45.41+$4.79
- Washington, DC area · District of Columbia$46.18+$5.56
- Miami, FL · Florida$44.27+$3.65
- Chicago, IL · Illinois$43.39+$2.77
- Manhattan, NY · New York$46.70+$6.08
- Alaska · Alaska$52.29+$11.67
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $38.37 | $25.22 |
| ArkansasArkansas | $37.99 | $25.08 |
| ArizonaArizona | $40.61 | $26.05 |
| Bakersfield, CACalifornia | $43.17 | $26.70 |
| Chico, CACalifornia | $43.04 | $26.56 |
| El Centro, CACalifornia | $43.04 | $26.57 |
| Fresno, CACalifornia | $43.04 | $26.56 |
| Hanford, CACalifornia | $43.04 | $26.56 |
| Madera, CACalifornia | $43.04 | $26.56 |
| Merced, CACalifornia | $43.04 | $26.56 |
| Modesto, CACalifornia | $43.04 | $26.56 |
| Napa, CACalifornia | $48.31 | $28.50 |
| Oxnard, CACalifornia | $45.07 | $27.30 |
| Redding, CACalifornia | $43.04 | $26.56 |
| Rest of CaliforniaCalifornia | $43.04 | $26.56 |
| Riverside, CACalifornia | $43.48 | $27.01 |
| Sacramento, CACalifornia | $44.74 | $27.26 |
| Salinas, CACalifornia | $44.56 | $27.14 |
| San Diego, CACalifornia | $45.28 | $27.30 |
| Marin County, CACalifornia | $50.71 | $29.52 |
| San Francisco, CACalifornia | $50.66 | $29.47 |
| San Benito County, CACalifornia | $51.75 | $30.07 |
| Santa Clara County, CACalifornia | $51.56 | $29.89 |
| San Luis Obispo, CACalifornia | $43.88 | $26.76 |
| Santa Cruz, CACalifornia | $45.46 | $27.20 |
| Santa Maria, CACalifornia | $44.64 | $27.11 |
| Santa Rosa, CACalifornia | $45.90 | $27.44 |
| Stockton, CACalifornia | $43.04 | $26.56 |
| Vallejo, CACalifornia | $48.24 | $28.43 |
| Visalia, CACalifornia | $43.04 | $26.56 |
| Yuba City, CACalifornia | $43.04 | $26.56 |
| ColoradoColorado | $42.63 | $26.64 |
| ConnecticutConnecticut | $43.62 | $27.43 |
| DelawareDelaware | $41.15 | $26.30 |
| Fort Lauderdale, FLFlorida | $42.75 | $27.53 |
| Rest of FloridaFlorida | $41.22 | $26.85 |
| Atlanta, GAGeorgia | $42.06 | $26.79 |
| Rest of GeorgiaGeorgia | $39.55 | $26.14 |
| Hawaii, Guam, HIHawaii | $43.55 | $26.46 |
| IowaIowa | $38.94 | $25.18 |
| IdahoIdaho | $39.14 | $25.31 |
| East St. Louis, ILIllinois | $41.20 | $27.37 |
| Rest of IllinoisIllinois | $40.45 | $26.73 |
| Suburban Chicago, ILIllinois | $43.12 | $27.69 |
| IndianaIndiana | $39.29 | $25.36 |
| KansasKansas | $38.86 | $25.28 |
| KentuckyKentucky | $39.12 | $25.75 |
| New Orleans, LALouisiana | $40.44 | $26.29 |
| Rest of LouisianaLouisiana | $39.09 | $25.79 |
| Metropolitan Boston, MAMassachusetts | $45.93 | $27.98 |
| Rest of MassachusettsMassachusetts | $42.52 | $26.69 |
| Baltimore area, MDMaryland | $43.50 | $27.37 |
| Rest of MarylandMaryland | $41.75 | $26.54 |
| Rest of MaineMaine | $39.34 | $25.51 |
| Southern Maine, MEMaine | $40.75 | $25.85 |
| Detroit, MIMichigan | $41.64 | $27.14 |
| Rest of MichiganMichigan | $39.87 | $26.15 |
| MinnesotaMinnesota | $41.05 | $25.58 |
| Metropolitan Kansas City, MOMissouri | $40.18 | $26.07 |
| Metropolitan St. Louis, MOMissouri | $40.47 | $26.16 |
| Rest of MissouriMissouri | $38.66 | $25.71 |
| MississippiMississippi | $38.33 | $25.39 |
| MontanaMontana | $41.41 | $26.38 |
| North CarolinaNorth Carolina | $39.61 | $25.59 |
| NebraskaNebraska | $39.07 | $25.20 |
| New HampshireNew Hampshire | $42.06 | $26.41 |
| Northern New JerseyNew Jersey | $45.94 | $28.51 |
| Rest of New JerseyNew Jersey | $44.17 | $27.76 |
| New MexicoNew Mexico | $40.05 | $26.27 |
| NevadaNevada | $41.21 | $26.17 |
| NYC suburbs and Long Island, NYNew York | $47.59 | $29.72 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $44.49 | $28.03 |
| Queens, NYNew York | $46.90 | $29.13 |
| Rest of New YorkNew York | $40.03 | $25.76 |
| OhioOhio | $39.71 | $25.99 |
| OklahomaOklahoma | $39.01 | $25.59 |
| Portland, OROregon | $43.59 | $26.89 |
| Rest of OregonOregon | $40.94 | $25.97 |
| Metropolitan Philadelphia, PAPennsylvania | $42.85 | $27.20 |
| Rest of PennsylvaniaPennsylvania | $39.73 | $25.93 |
| Puerto RicoPuerto Rico | $41.61 | $26.42 |
| Rhode IslandRhode Island | $42.31 | $26.78 |
| South CarolinaSouth Carolina | $39.72 | $25.83 |
| South DakotaSouth Dakota | $40.53 | $25.50 |
| TennesseeTennessee | $39.01 | $25.34 |
| Austin, TXTexas | $42.45 | $26.55 |
| Beaumont, TXTexas | $39.55 | $25.87 |
| Brazoria, TXTexas | $41.11 | $26.21 |
| Dallas, TXTexas | $41.33 | $26.36 |
| Fort Worth, TXTexas | $41.15 | $26.33 |
| Galveston, TXTexas | $41.21 | $26.29 |
| Houston, TXTexas | $41.94 | $27.02 |
| Rest of TexasTexas | $40.28 | $26.02 |
| UtahUtah | $40.10 | $25.97 |
| VirginiaVirginia | $40.69 | $25.91 |
| Virgin Islands, VIUnited States Virgin Islands | $41.61 | $26.42 |
| VermontVermont | $40.56 | $25.68 |
| Rest of WashingtonWashington | $42.41 | $26.58 |
| King County, WAWashington | $46.66 | $28.22 |
| WisconsinWisconsin | $39.66 | $25.27 |
| West VirginiaWest Virginia | $39.41 | $26.35 |
| WyomingWyoming | $41.07 | $26.04 |
99458 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.
$37.99
$52.29
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 | $52.29 | 1 |
| AL | $38.37 | 1 |
| AR | $37.99 | 1 |
| AZ | $40.61 | 1 |
| CA | $43.04–$51.75 | 29 |
| CO | $42.63 | 1 |
| CT | $43.62 | 1 |
| DC | $46.18 | 1 |
| DE | $41.15 | 1 |
| FL | $41.22–$44.27 | 3 |
| GA | $39.55–$42.06 | 2 |
| GU | $43.55 | 1 |
| HI | $43.55 | 1 |
| IA | $38.94 | 1 |
| ID | $39.14 | 1 |
| IL | $40.45–$43.39 | 4 |
| IN | $39.29 | 1 |
| KS | $38.86 | 1 |
| KY | $39.12 | 1 |
| LA | $39.09–$40.44 | 2 |
| MA | $42.52–$45.93 | 2 |
| MD | $41.75–$46.18 | 3 |
| ME | $39.34–$40.75 | 2 |
| MI | $39.87–$41.64 | 2 |
| MN | $41.05 | 1 |
| MO | $38.66–$40.47 | 3 |
| MS | $38.33 | 1 |
| MT | $41.41 | 1 |
| NC | $39.61 | 1 |
| ND | $40.62 | 1 |
| NE | $39.07 | 1 |
| NH | $42.06 | 1 |
| NJ | $44.17–$45.94 | 2 |
| NM | $40.05 | 1 |
| NV | $41.21 | 1 |
| NY | $40.03–$47.59 | 5 |
| OH | $39.71 | 1 |
| OK | $39.01 | 1 |
| OR | $40.94–$43.59 | 2 |
| PA | $39.73–$42.85 | 2 |
| PR | $41.61 | 1 |
| RI | $42.31 | 1 |
| SC | $39.72 | 1 |
| SD | $40.53 | 1 |
| TN | $39.01 | 1 |
| TX | $39.55–$42.45 | 8 |
| UT | $40.10 | 1 |
| VA | $40.69–$46.18 | 2 |
| VI | $41.61 | 1 |
| VT | $40.56 | 1 |
| WA | $42.41–$46.66 | 2 |
| WI | $39.66 | 1 |
| WV | $39.41 | 1 |
| WY | $41.07 | 1 |
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.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,125
- Code
- 99458
- Physician work
- 0.61
- Practice expense
- 0.59
- Malpractice
- 0.04
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.61 | × 1.000 | 0.6100 |
| Practice expense | 0.59 | × 1.000 | 0.5900 |
| Malpractice | 0.04 | × 0.406 | 0.0162 |
| Total RVUs | 1.2162 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$40.62
Office: (0.61 × 1 + 0.59 × 1 + 0.04 × 0.406) × $33.4009 = $40.62
Facility: (0.61 × 1 + 0.14 × 1 + 0.04 × 0.406) × $33.4009 = $25.59
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. |
How 99458 has changed in North Dakota
99458 · Office / nonfacility
$40.62
Effective 2026-10-01
The base rate is $2.75 higher than on 2025-10-01, moving from $37.87 to $40.62 (7.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$37.87changed to$40.62
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.54 changed to 0.59
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$38.64changed to$37.87
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.53 changed to 0.54
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$38.01changed to$38.64
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$38.94changed to$38.01
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.52 changed to 0.53
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$40.05changed to$38.94
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.53 changed to 0.52
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$40.38changed to$40.05
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$41.30changed to$40.38
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.51 changed to 0.53
- Malpractice RVU 0.05 changed to 0.04
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$41.30
Held through RVU20B, RVU20C, RVU20D.
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, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $40.62 | $25.59 | RVU26D |
| 2026-07-01 | $40.62 | $25.59 | RVU26C |
| 2026-04-01 | $40.62 | $25.59 | RVU26B |
| 2026-01-01 | $40.62 | $25.59 | RVU26A |
| 2025-10-01 | $37.87 | $28.16 | RVU25D |
| 2025-07-01 | $37.87 | $28.16 | RVU25C |
| 2025-04-01 | $37.87 | $28.16 | RVU25B |
| 2025-01-01 | $37.87 | $28.16 | RVU25A |
| 2024-10-01 | $38.64 | $28.98 | RVU24D |
| 2024-07-01 | $38.64 | $28.98 | RVU24C |
| 2024-04-01 | $38.64 | $28.98 | RVU24B |
| 2024-03-09 | $38.64 | $28.98 | RVU24AR |
| 2024-01-01 | $38.01 | $28.51 | RVU24A |
| 2023-10-01 | $38.94 | $29.45 | RVU23D |
| 2023-07-01 | $38.94 | $29.45 | RVU23C |
| 2023-04-01 | $38.94 | $29.45 | RVU23B |
| 2023-01-01 | $38.94 | $29.45 | RVU23A |
| 2022-10-01 | $40.05 | $30.36 | RVU22D |
| 2022-07-01 | $40.05 | $30.36 | RVU22C |
| 2022-04-01 | $40.05 | $30.36 | RVU22B |
| 2022-01-01 | $40.05 | $30.36 | RVU22A |
| 2021-10-01 | $40.38 | $30.96 | RVU21D |
| 2021-07-01 | $40.38 | $30.96 | RVU21C |
| 2021-04-01 | $40.38 | $30.96 | RVU21B |
| 2021-01-01 | $40.38 | $30.96 | RVU21A |
| 2020-10-01 | $41.30 | $31.91 | RVU20D |
| 2020-07-01 | $41.30 | $31.91 | RVU20C |
| 2020-04-01 | $41.30 | $31.91 | RVU20B |
| 2020-01-01 | $41.30 | $31.91 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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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