CPT code 99495: Transitional care management, moderate complexity, visit within 14 days2026 Medicare rate & RVUs in Alaska

Report transitional care management after a qualifying discharge when timely contact, at least moderate-complexity decision making, and a visit within 14 days are documented.

CMS RVU26DEffective Oct 1, 2026One payment locality723.7K Medicare services in 2024

In Alaska, Medicare pays $271.55 for 99495 in the office and $167.32 when it’s performed in a hospital or facility.

$271.55Office (non-facility)
$167.32Hospital or facility
+23.4%vs the national office rate ($220.11)

Check a contract rate as a % of Medicare · 99495 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 99495 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alaska
  2. What 99495 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 99495 covers

This service covers a practitioner's management of a patient returning to a community setting after an inpatient hospital stay, observation, skilled nursing facility stay, inpatient rehabilitation, or partial hospitalization. The 30-day period begins on the discharge date. The practice must make interactive contact with the patient or caregiver within two business days. A face-to-face visit must occur within 14 calendar days; medication reconciliation must occur by that visit. Other work may include reviewing discharge records, following up on pending tests, arranging referrals, and educating the family. Primary care physicians, NPs, and PAs commonly report the service, with clinical staff helping with outreach.

Select 99495 when medical decision making is at least moderate and the visit occurs within 14 calendar days; high-complexity decision making with a visit within seven days instead meets the timing and complexity criteria for 99496. Document the discharge date, timely contact or contact attempts, visit date, medication reconciliation, and decision making. Only one practitioner reports transitional care management for a patient's 30-day period, once per period. The required face-to-face visit is included rather than billed as a separate E/M visit.

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 Alaska compares for 99495

Across 109 of 109 payment localities, the office rate for 99495 runs from $199.99 in Arkansas to $280.82 in San Benito County, CA. Alaska pays $271.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

99495 in Alaska vs other payment areas
  1. Alaska · this page$271.55
  2. Los Angeles, CA · California$243.91−$27.64
  3. Washington, DC area · District of Columbia$247.37−$24.18
  4. Miami, FL · Florida$234.77−$36.78
  5. Chicago, IL · Illinois$229.58−$41.97
  6. Manhattan, NY · New York$249.36−$22.19
  7. Alabama · Alabama$202.24−$69.31

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

Every other payment area

99495 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$199.99$115.92
ArizonaArizona$215.45$120.62
Bakersfield, CACalifornia$231.00$123.74
Chico, CACalifornia$230.35$123.09
El Centro, CACalifornia$230.39$123.13
Fresno, CACalifornia$230.35$123.09
Hanford, CACalifornia$230.35$123.09
Madera, CACalifornia$230.35$123.09

99495 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.

$199.99

$271.55

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99495 office rate range by state
State / territoryOffice rate rangeLocalities
AK$271.551
AL$202.241
AR$199.991
AZ$215.451
CA$230.35–$280.8229
CO$227.571
CT$232.611
DC$247.371
DE$218.481
FL$217.98–$234.773
GA$208.27–$223.602
GU$234.011
HI$234.011
IA$206.011
ID$207.091
IL$213.17–$229.584
IN$208.021
KS$205.361
KY$206.151
LA$205.94–$213.842
MA$226.72–$246.682
MD$221.97–$247.373
ME$208.04–$216.682
MI$210.41–$220.232
MN$219.151
MO$203.26–$214.323
MS$201.651
MT$220.101
NC$209.721
ND$216.341
NE$206.851
NH$224.281
NJ$235.57–$245.742
NM$211.351
NV$219.171
NY$212.18–$254.355
OH$209.641
OK$205.761
OR$217.74–$233.392
PA$209.85–$227.972
PR$221.351
RI$225.181
SC$209.971
SD$215.901
TN$206.171
TX$208.78–$226.598
UT$212.211
VA$216.19–$247.372
VI$221.351
VT$215.771
WA$226.21–$251.042
WI$210.641
WV$207.011
WY$218.461

See 99495 in every payment locality

How the 99495 rate is calculated

Each of 99495’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 · 99495

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.78

2.78 RVUs× 1.000 GPCI

Practice expense3.62

3.62 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

6.5900

Conversion factor

$33.4009

Medicare rate

$220.11

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

The exact Alaska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,159

Code
99495
Physician work
2.78
Practice expense
3.62
Malpractice
0.19

GPCI2026.csv

5

Locality
Alaska
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Office calculation for 99495 in Alaska
ComponentRVULocality factorAdjusted
Physician work2.78× 1.5004.1700
Practice expense3.62× 1.0653.8553
Malpractice0.19× 0.5510.1047
Total RVUs8.1300
Conversion factor× 33.4009

Office rate, Alaska$271.55

Office: (2.78 × 1.5 + 3.62 × 1.065 + 0.19 × 0.551) × $33.4009 = $271.55

Facility: (2.78 × 1.5 + 0.69 × 1.065 + 0.19 × 0.551) × $33.4009 = $167.32

Open 99495 in the RVU calculator

Payment rules and modifiers for 99495

99495 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 · 99495

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$220.11

Non-facility (office)
$220.11
Facility
$122.25

Higher because the practice carries its own overhead.

How 99495 has changed in Alaska

99495 · Office / nonfacility

$271.55

Effective 2026-10-01

The base rate is $19.07 higher than on 2025-10-01, moving from $252.48 to $271.55 (7.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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, 2026

    RVU26A

    $252.48changed to$271.55

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.27 changed to 3.62
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 1.081 changed to 1.065
    • Malpractice GPCI 0.592 changed to 0.551

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $259.30changed to$252.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.25 changed to 3.27
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $255.07changed to$259.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $260.54changed to$255.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.10 changed to 3.25
    • Practice expense GPCI 1.100 changed to 1.081
    • Malpractice GPCI 0.603 changed to 0.592
  5. January 1, 2023

    RVU23A

    $267.12changed to$260.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.07 changed to 3.10
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 1.118 changed to 1.100
    • Malpractice GPCI 0.614 changed to 0.603

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $266.57changed to$267.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.01 changed to 3.07
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $240.20changed to$266.57

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 2.36 changed to 2.78
    • Practice expense RVU 2.71 changed to 3.01
    • Malpractice RVU 0.13 changed to 0.17
    • Malpractice GPCI 0.661 changed to 0.614

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $213.19changed to$240.20

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 2.11 changed to 2.36
    • Practice expense RVU 2.38 changed to 2.71
    • Practice expense GPCI 1.117 changed to 1.118
    • Malpractice GPCI 0.708 changed to 0.661

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $213.76changed to$213.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.40 changed to 2.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $211.48changed to$213.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.37 changed to 2.40
    • Practice expense GPCI 1.112 changed to 1.117
    • Malpractice GPCI 0.710 changed to 0.708

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $210.97changed to$211.48

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.38 changed to 2.37
    • Practice expense GPCI 1.107 changed to 1.112
    • Malpractice GPCI 0.712 changed to 0.710

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $211.98changed to$210.97

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.14 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $210.93changed to$211.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $207.70changed to$210.93

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.34 changed to 2.38
    • Malpractice RVU 0.13 changed to 0.14
    • Practice expense GPCI 1.087 changed to 1.107
    • Malpractice GPCI 0.687 changed to 0.712

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $204.13changed to$207.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.57 changed to 2.34
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 1.067 changed to 1.087
    • Malpractice GPCI 0.661 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $204.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$271.55$167.32RVU26D
2026-07-01$271.55$167.32RVU26C
2026-04-01$271.55$167.32RVU26B
2026-01-01$271.55$167.32RVU26A
2025-10-01$252.48$180.10RVU25D
2025-07-01$252.48$180.10RVU25C
2025-04-01$252.48$180.10RVU25B
2025-01-01$252.48$180.10RVU25A
2024-10-01$259.30$185.54RVU24D
2024-07-01$259.30$185.54RVU24C
2024-04-01$259.30$185.54RVU24B
2024-03-09$259.30$185.54RVU24AR
2024-01-01$255.07$182.51RVU24A
2023-10-01$260.54$188.60RVU23D
2023-07-01$260.54$188.60RVU23C
2023-04-01$260.54$188.60RVU23B
2023-01-01$260.54$188.60RVU23A
2022-10-01$267.12$195.16RVU22D
2022-07-01$267.12$195.16RVU22C
2022-04-01$267.12$195.16RVU22B
2022-01-01$267.12$195.16RVU22A
2021-10-01$266.57$196.35RVU21D
2021-07-01$266.57$196.35RVU21C
2021-04-01$266.57$196.35RVU21B
2021-01-01$266.57$196.35RVU21A
2020-10-01$240.20$170.80RVU20D
2020-07-01$240.20$170.80RVU20C
2020-04-01$240.20$170.80RVU20B
2020-01-01$240.20$170.80RVU20A
2019-10-01$213.19$152.40RVU19D
2019-07-01$213.19$152.40RVU19C
2019-04-01$213.19$152.40RVU19B
2019-01-01$213.19$152.40RVU19A
2018-10-01$213.76$152.64RVU18D
2018-07-01$213.76$152.64RVU18C
2018-04-01$213.76$152.64RVU18B
2018-01-01$213.76$152.64RVU18AR1
2017-10-01$211.48$152.02RVU17D
2017-07-01$211.48$152.02RVU17C
2017-04-01$211.48$152.02RVU17B
2017-01-01$211.48$152.02RVU17A
2016-10-01$210.97$151.12RVU16D
2016-07-01$210.97$151.12RVU16C
2016-04-01$210.97$151.12RVU16B
2016-01-01$210.97$151.12RVU16A
2015-10-01$211.98$152.32RVU15D
2015-07-01$211.98$152.32RVU15C
2015-04-01$210.93$151.56RVU15B
2015-01-01$210.93$151.56RVU15A
2014-10-01$207.70$150.46RVU14D
2014-07-01$207.70$150.46RVU14C
2014-04-01$207.70$150.46RVU14B
2014-01-01$207.70$150.46RVU14A
2013-10-01$204.13$172.91RVU13D
2013-07-01$204.13$172.91RVU13C
2013-04-01$204.13$172.91RVU13B
2013-01-01$204.13$172.91RVU13AR

Price 99495 for an earlier date of service

Where the Alaska rate applies

Alaska is a Medicare payment area, not a city. Our Census mapping connects it to 355 cities and communities in Alaska. Some span more than one payment area; confirm with the service ZIP.

  • Adak
  • Akhiok
  • Akiachak
  • Akiak
  • Akutan
  • Alakanuk
  • Alatna
  • Alcan Border

Browse all communities in Alaska

99495 billing questions

How do I choose between 99495 and 99496?

99496 requires high-complexity decision making and a face-to-face visit within seven calendar days of discharge. Report 99495 for moderate-complexity decision making with a visit within 14 days, or high-complexity decision making with a visit on days 8 through 14.

Can I bill the face-to-face visit separately as an office visit?

No. The required face-to-face visit is included in 99495. Additional medically necessary E/M visits later in the 30-day period may be reported separately.

What if the two-business-day contact was not successful?

CMS accepts two or more separately documented, unsuccessful contact attempts within the two business days. Continue trying to reach the patient or caregiver; if the remaining requirements are met, the service may still be reported.

What date of service should go on the claim, and when can it be submitted?

Use the date of the face-to-face visit as the date of service. CMS allows submission once that visit has been furnished, without waiting for the 30-day period to end.

Can the face-to-face visit be done by telehealth?

Yes. The required visit can be furnished by telehealth when Medicare telehealth billing requirements are met.

Can the discharging physician also bill 99495?

Yes. A physician who reports discharge day management may also report transitional care management, but the required face-to-face visit cannot occur on the discharge service date.

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
RVUs for 99495PPRRVU2026_Oct_nonQPP.csv, line 13,159 (RVU26D)
Geographic factors for AlaskaGPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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