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CMS RVU26D · Effective 2026-10-01

99458 in Austin

Office / nonfacility

$42.45

Base rate per service

Facility setting

$26.55

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Remote patient monitoring

About 99458: Remote physiologic monitoring management, each additional 20 minutes

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.

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.

CMS billing rules for 99458

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU0.61 · 49%
  • Practice expense (office) RVU0.59 · 48%
  • Malpractice RVU0.04 · 3%

2.2M

Medicare services in 2024 · #76 by national volume

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.

99458 compared with similar codes

Office rates for Austin, from the same CMS release.

99457

RPM management

First 20 minutes per month

$53.40

99457 covers the first 20 minutes of monthly RPM management, including interactive communication. Report 99458 with it only for each further full 20 minutes.

99470

RPM management

First 10 minutes

$26.87

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.

98981

RTM management

Each additional 20 minutes

$42.51

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.

99454

RPM device supply

16-30 days of readings

$55.07

99454 covers the RPM device supply and transmission of readings for a qualifying monitoring period; 99458 covers additional treatment management time.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 99458 is $39.55—$2.90 lower than the $42.45 rate in Austin. Both use the same code, release and participation basis.

99458 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $42.45

  2. Beaumont

    $39.55

    $2.90 lower than Austin

  3. Brazoria

    $41.11

    $1.34 lower than Austin

  4. Dallas

    $41.33

    $1.12 lower than Austin

  5. Fort Worth

    $41.15

    $1.30 lower than Austin

  6. Galveston

    $41.21

    $1.24 lower than Austin

  7. Houston

    $41.94

    $0.51 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 99458 ranges from $37.99 in Arkansas to $52.29 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 99458

    Office

    $40.28

    Facility

    $26.02

    $2.17 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 99458

    Office

    $45.41

    Facility

    $27.63

    $2.96 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99458

    Office

    $46.18

    Facility

    $28.47

    $3.73 higher than Austin for the office setting.

  • Miami

    Florida · 99458

    Office

    $44.27

    Facility

    $28.62

    $1.82 higher than Austin for the office setting.

  • Chicago

    Illinois · 99458

    Office

    $43.39

    Facility

    $28.28

    $0.94 higher than Austin for the office setting.

  • Manhattan

    New York · 99458

    Office

    $46.70

    Facility

    $29.23

    $4.25 higher than Austin for the office setting.

  • Alaska*

    Alaska · 99458

    Office

    $52.29

    Facility

    $36.28

    $9.84 higher than Austin for the office setting.

  • Alabama

    Alabama · 99458

    Office

    $38.37

    Facility

    $25.22

    $4.08 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 99458

    Office

    $37.99

    Facility

    $25.08

    $4.46 lower than Austin for the office setting.

  • Arizona

    Arizona · 99458

    Office

    $40.61

    Facility

    $26.05

    $1.84 lower than Austin for the office setting.

  • Bakersfield

    California · 99458

    Office

    $43.17

    Facility

    $26.70

    $0.72 higher than Austin for the office setting.

  • Chico

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • El Centro

    California · 99458

    Office

    $43.04

    Facility

    $26.57

    $0.59 higher than Austin for the office setting.

  • Fresno

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Madera

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Merced

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Modesto

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Napa

    California · 99458

    Office

    $48.31

    Facility

    $28.50

    $5.86 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99458

    Office

    $45.07

    Facility

    $27.30

    $2.62 higher than Austin for the office setting.

  • Redding

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Rest Of California

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99458

    Office

    $43.48

    Facility

    $27.01

    $1.03 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99458

    Office

    $44.74

    Facility

    $27.26

    $2.29 higher than Austin for the office setting.

  • Salinas

    California · 99458

    Office

    $44.56

    Facility

    $27.14

    $2.11 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99458

    Office

    $45.28

    Facility

    $27.30

    $2.83 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99458

    Office

    $50.71

    Facility

    $29.52

    $8.26 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 99458

    Office

    $50.66

    Facility

    $29.47

    $8.21 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 99458

    Office

    $51.75

    Facility

    $30.07

    $9.30 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 99458

    Office

    $51.56

    Facility

    $29.89

    $9.11 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99458

    Office

    $43.88

    Facility

    $26.76

    $1.43 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 99458

    Office

    $45.46

    Facility

    $27.20

    $3.01 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 99458

    Office

    $44.64

    Facility

    $27.11

    $2.19 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 99458

    Office

    $45.90

    Facility

    $27.44

    $3.45 higher than Austin for the office setting.

  • Stockton

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Vallejo

    California · 99458

    Office

    $48.24

    Facility

    $28.43

    $5.79 higher than Austin for the office setting.

  • Visalia

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Yuba City

    California · 99458

    Office

    $43.04

    Facility

    $26.56

    $0.59 higher than Austin for the office setting.

  • Colorado

    Colorado · 99458

    Office

    $42.63

    Facility

    $26.64

    $0.18 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 99458

    Office

    $43.62

    Facility

    $27.43

    $1.17 higher than Austin for the office setting.

  • Delaware

    Delaware · 99458

    Office

    $41.15

    Facility

    $26.30

    $1.30 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 99458

    Office

    $42.75

    Facility

    $27.53

    $0.30 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 99458

    Office

    $41.22

    Facility

    $26.85

    $1.23 lower than Austin for the office setting.

  • Atlanta

    Georgia · 99458

    Office

    $42.06

    Facility

    $26.79

    $0.39 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 99458

    Office

    $39.55

    Facility

    $26.14

    $2.90 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 99458

    Office

    $43.55

    Facility

    $26.46

    $1.10 higher than Austin for the office setting.

  • Iowa

    Iowa · 99458

    Office

    $38.94

    Facility

    $25.18

    $3.51 lower than Austin for the office setting.

  • Idaho

    Idaho · 99458

    Office

    $39.14

    Facility

    $25.31

    $3.31 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 99458

    Office

    $41.20

    Facility

    $27.37

    $1.25 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 99458

    Office

    $40.45

    Facility

    $26.73

    $2.00 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 99458

    Office

    $43.12

    Facility

    $27.69

    $0.67 higher than Austin for the office setting.

  • Indiana

    Indiana · 99458

    Office

    $39.29

    Facility

    $25.36

    $3.16 lower than Austin for the office setting.

  • Kansas

    Kansas · 99458

    Office

    $38.86

    Facility

    $25.28

    $3.59 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 99458

    Office

    $39.12

    Facility

    $25.75

    $3.33 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 99458

    Office

    $40.44

    Facility

    $26.29

    $2.01 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 99458

    Office

    $39.09

    Facility

    $25.79

    $3.36 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 99458

    Office

    $45.93

    Facility

    $27.98

    $3.48 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99458

    Office

    $42.52

    Facility

    $26.69

    $0.07 higher than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99458

    Office

    $43.50

    Facility

    $27.37

    $1.05 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 99458

    Office

    $41.75

    Facility

    $26.54

    $0.70 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 99458

    Office

    $39.34

    Facility

    $25.51

    $3.11 lower than Austin for the office setting.

  • Southern Maine

    Maine · 99458

    Office

    $40.75

    Facility

    $25.85

    $1.70 lower than Austin for the office setting.

  • Detroit

    Michigan · 99458

    Office

    $41.64

    Facility

    $27.14

    $0.81 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 99458

    Office

    $39.87

    Facility

    $26.15

    $2.58 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 99458

    Office

    $41.05

    Facility

    $25.58

    $1.40 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 99458

    Office

    $40.18

    Facility

    $26.07

    $2.27 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 99458

    Office

    $40.47

    Facility

    $26.16

    $1.98 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 99458

    Office

    $38.66

    Facility

    $25.71

    $3.79 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 99458

    Office

    $38.33

    Facility

    $25.39

    $4.12 lower than Austin for the office setting.

  • Montana**

    Montana · 99458

    Office

    $41.41

    Facility

    $26.38

    $1.04 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 99458

    Office

    $39.61

    Facility

    $25.59

    $2.84 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 99458

    Office

    $40.62

    Facility

    $25.59

    $1.83 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 99458

    Office

    $39.07

    Facility

    $25.20

    $3.38 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 99458

    Office

    $42.06

    Facility

    $26.41

    $0.39 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 99458

    Office

    $45.94

    Facility

    $28.51

    $3.49 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 99458

    Office

    $44.17

    Facility

    $27.76

    $1.72 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 99458

    Office

    $40.05

    Facility

    $26.27

    $2.40 lower than Austin for the office setting.

  • Nevada**

    Nevada · 99458

    Office

    $41.21

    Facility

    $26.17

    $1.24 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99458

    Office

    $47.59

    Facility

    $29.72

    $5.14 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99458

    Office

    $44.49

    Facility

    $28.03

    $2.04 higher than Austin for the office setting.

  • Queens

    New York · 99458

    Office

    $46.90

    Facility

    $29.13

    $4.45 higher than Austin for the office setting.

  • Rest Of New York

    New York · 99458

    Office

    $40.03

    Facility

    $25.76

    $2.42 lower than Austin for the office setting.

  • Ohio

    Ohio · 99458

    Office

    $39.71

    Facility

    $25.99

    $2.74 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 99458

    Office

    $39.01

    Facility

    $25.59

    $3.44 lower than Austin for the office setting.

  • Portland

    Oregon · 99458

    Office

    $43.59

    Facility

    $26.89

    $1.14 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 99458

    Office

    $40.94

    Facility

    $25.97

    $1.51 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99458

    Office

    $42.85

    Facility

    $27.20

    $0.40 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99458

    Office

    $39.73

    Facility

    $25.93

    $2.72 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 99458

    Office

    $41.61

    Facility

    $26.42

    $0.84 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 99458

    Office

    $42.31

    Facility

    $26.78

    $0.14 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 99458

    Office

    $39.72

    Facility

    $25.83

    $2.73 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 99458

    Office

    $40.53

    Facility

    $25.50

    $1.92 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 99458

    Office

    $39.01

    Facility

    $25.34

    $3.44 lower than Austin for the office setting.

  • Utah

    Utah · 99458

    Office

    $40.10

    Facility

    $25.97

    $2.35 lower than Austin for the office setting.

  • Virginia

    Virginia · 99458

    Office

    $40.69

    Facility

    $25.91

    $1.76 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99458

    Office

    $41.61

    Facility

    $26.42

    $0.84 lower than Austin for the office setting.

  • Vermont

    Vermont · 99458

    Office

    $40.56

    Facility

    $25.68

    $1.89 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 99458

    Office

    $42.41

    Facility

    $26.58

    $0.04 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 99458

    Office

    $46.66

    Facility

    $28.22

    $4.21 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 99458

    Office

    $39.66

    Facility

    $25.27

    $2.79 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 99458

    Office

    $39.41

    Facility

    $26.35

    $3.04 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 99458

    Office

    $41.07

    Facility

    $26.04

    $1.38 lower than Austin for the office setting.

See how rates vary across the country

99458 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 all state and territory rates as a table
State / territoryRate rangeLocalities
AK$52.291
AL$38.371
AR$37.991
AZ$40.611
CA$43.04–$51.7529
CO$42.631
CT$43.621
DC$46.181
DE$41.151
FL$41.22–$44.273
GA$39.55–$42.062
GU$43.551
HI$43.551
IA$38.941
ID$39.141
IL$40.45–$43.394
IN$39.291
KS$38.861
KY$39.121
LA$39.09–$40.442
MA$42.52–$45.932
MD$41.75–$46.183
ME$39.34–$40.752
MI$39.87–$41.642
MN$41.051
MO$38.66–$40.473
MS$38.331
MT$41.411
NC$39.611
ND$40.621
NE$39.071
NH$42.061
NJ$44.17–$45.942
NM$40.051
NV$41.211
NY$40.03–$47.595
OH$39.711
OK$39.011
OR$40.94–$43.592
PA$39.73–$42.852
PR$41.611
RI$42.311
SC$39.721
SD$40.531
TN$39.011
TX$39.55–$42.458
UT$40.101
VA$40.69–$46.182
VI$41.611
VT$40.561
WA$42.41–$46.662
WI$39.661
WV$39.411
WY$41.071

Explore 99458 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 99458 in Austin, the physician’s office rate is $42.45 and the facility-setting rate is $26.55: a difference of $15.90.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99458 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$46.70

$42.45 × 110% = $46.70

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99458 in Austin.

PPRRVU2026_Oct_nonQPP.csv

13,125

Code
99458
Physician work
0.61
Practice expense
0.59
Malpractice
0.04

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 99458 in Austin
ComponentRVULocality factorAdjusted
Physician work0.61× 1.0020.6112
Practice expense0.59× 1.0580.6242
Malpractice0.04× 0.8860.0354
Total RVUs1.2709
Conversion factor× 33.4009

Office / nonfacility rate, Austin$42.45

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 99458 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.611.002
Practice expense0.591.058
Malpractice0.040.886

(0.61 × 1.002 + 0.59 × 1.058 + 0.04 × 0.886) × $33.4009 = $42.45

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.611.002
Practice expense0.141.058
Malpractice0.040.886

(0.61 × 1.002 + 0.14 × 1.058 + 0.04 × 0.886) × $33.4009 = $26.55

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

99458 · Office / nonfacility

$42.45

Effective 2026-10-01

The base rate is $3.27 higher than on 2025-10-01, moving from $39.18 to $42.45 (8.3%).

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

    $39.18changed to$42.45

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.54 changed to 0.59
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $39.18

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$42.45$26.55RVU26D
2026-07-01$42.45$26.55RVU26C
2026-04-01$42.45$26.55RVU26B
2026-01-01$42.45$26.55RVU26A
2025-10-01$39.18$29.03RVU25D
2025-07-01$39.18$29.03RVU25C
2025-04-01$39.18$29.03RVU25B
2025-01-01$39.18$29.03RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 99458PPRRVU2026_Oct_nonQPP.csv, line 13,125 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet