CPT code 99474: Blood pressure monitoring, 30-day data review and plan2026 Medicare rate & RVUs in California

Medicare pays $19.47–$24.19 for 99474 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.

What 99474 covers

This service covers review of a patient’s self-measured blood pressure readings over 30 days, reporting the average systolic and diastolic pressures, and communicating a treatment plan. It is commonly used in outpatient hypertension care when a clinician needs home readings to assess blood pressure control or guide management. The patient or caregiver takes the readings at home; the treating physician or other qualified health care professional reviews the data and communicates the plan.

Report the service for the 30-day monitoring period, not for each individual reading. Documentation should support the monitoring period, the required pattern of at least two readings daily, the calculated averages, and communication of the treatment plan to the patient. The Medicare Physician Fee Schedule assigns work, practice-expense, and malpractice values to the service, with office and facility practice-expense values reported separately. The code represents the monitoring review and communication work for the 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 99474 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 of 29 payment localities

How the 99474 rate is calculated

Each of 99474’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.

Payment rules and modifiers for 99474

99474 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.

99474 compared with similar codes

How to choose

99473BP device trainingEducation and calibration

Choose 99473 for patient education and device setup. Choose this code for the 30-day collection and review of readings, averages, and treatment-plan communication.

99470RPM managementFirst 10 minutes

99470 describes remote physiologic monitoring treatment management with a time-based structure. This code is specific to self-measured blood pressure data collected over 30 days.

99457RPM managementFirst 20 minutes per month

99457 is a remote physiologic monitoring treatment-management service. This code instead requires the specified pattern of self-measured blood pressure readings and reporting of their averages.

Codes related to 99474

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

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