No office rate
99231 represents subsequent hospital E/M care. G0459 is specific to inpatient pharmacologic management delivered by telehealth.
On this page
CMS RVU26D · Effective 2026-10-01
G0459 Medication management Medicare reimbursement rates in Connecticut
G0459 reports physician or qualified professional medication management delivered by telehealth to a patient receiving inpatient care. Compare G0459 office and facility rates across CMS payment localities in Connecticut.
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.
What does Medicare pay for G0459 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$41.27
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Telehealth services
About G0459: Inpatient telehealth medication management
G0459 reports physician or qualified professional medication management delivered by telehealth to a patient receiving inpatient care.
G0459 describes medication management furnished by telehealth to a patient in an inpatient setting. A physician or other qualified health care professional reviews the patient’s medication regimen and manages pharmacologic treatment, which may include prescription decisions. The code is specific to inpatient medication management delivered remotely; it is not a code for dispensing or administering a medication. Typical documentation identifies the patient’s inpatient status, the telehealth service, the medications reviewed, and the clinician’s assessment and management decisions.
Report G0459 when the service furnished matches inpatient telehealth pharmacologic management, rather than using it for a general telehealth encounter or an in-person visit. The record should make clear what medication issues were assessed and what treatment decisions followed. CMS physician fee schedule data assigns work, practice-expense, and malpractice relative values to this service. The supplied CMS facts list no additional payment rules for G0459.
Where the value comes from
- Work RVU0.95 · 80%
- Practice expense (office) RVU0.18 · 15%
- Malpractice RVU0.06 · 5%
2.3K
Medicare services in 2024 · #2344 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.
G0459 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
99232 is a subsequent hospital E/M level selected under E/M criteria; it does not identify the telehealth medication-management service described by G0459.
No office rate
99233 represents a higher-level subsequent hospital E/M service. G0459 identifies inpatient pharmacologic management via telehealth, not an E/M level.
Compare G0459 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
Unavailable
Facility
$41.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 G0459 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
15,277
- Code
- G0459
- Physician work
- 0.95
- Practice expense
- 0.18
- Malpractice
- 0.06
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.95 | × 1.020 | 0.9690 |
| Practice expense | 0.18 | × 1.077 | 0.1939 |
| Malpractice | 0.06 | × 1.210 | 0.0726 |
| Total RVUs | 1.2355 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$41.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.95 | 1.02 |
| Practice expense | 0.18 | 1.077 |
| Malpractice | 0.06 | 1.21 |
(0.95 × 1.02 + 0.18 × 1.077 + 0.06 × 1.21) × $33.4009 = $41.27
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.
G0459 billing questions
When should G0459 be selected instead of an inpatient E/M code?
Use G0459 for inpatient pharmacologic management delivered by telehealth. An inpatient E/M code describes a hospital evaluation and management service, with the level selected under the applicable E/M criteria.
Can G0459 be reported for an in-person medication review?
No. G0459 is specifically for inpatient pharmacologic management provided via telehealth.
What documentation supports G0459?
Document the patient’s inpatient status, the telehealth encounter, the medications reviewed, the clinical assessment, and any resulting medication or prescription decisions.
Does G0459 include medication administration?
G0459 describes professional medication management, including review and prescription decisions. It does not describe administering or dispensing a drug.
Is G0459 selected by time or billed in multiple units?
The supplied CMS facts do not specify a time threshold or unit convention. The record should support the inpatient telehealth medication-management service represented by the code.
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.
15,274G0454,,Md document visit by npp,A,,0.18,0.08,,0.04,,0.01,0.27,0.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,275G0455,,Fecal microbiota prep instil,A,,1.31,2.93,,0.39,,0.14,4.38,1.84,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,276G0458,,Ldr prostate brachy comp rat,E,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,277G0459,,Telehealth inpt pharm mgmt,A,,0.95,0.18,NA,0.18,,0.06,1.19,1.19,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,278G0460,,Autolog prp not diab ulcer,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,279G0463,,Hospital outpt clinic visit,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,280G0465,,Autolog prp diab wound ulcer,A,,1.78,29.91,,0.58,,0.15,31.84,2.51,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808