Billing code 59020: Fetal stress testMedicare rate & RVUs in Guam
Reports antepartum fetal assessment that monitors the fetal heart rate response to uterine contractions, including contractions induced for the test.
Medicare pays $76.32 for 59020 in the office in Guam (Hawaii, Guam). 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.
On this page 9 sections
What 59020 covers
An obstetric clinician uses fetal heart rate and uterine activity monitoring to assess how the fetus responds to contractions. Contractions may occur spontaneously or be induced for testing. The service is generally performed in an obstetric setting when fetal status needs assessment before labor; it is distinct from monitoring a fetus during labor. The record should identify the reason for testing and include the monitoring findings and interpretation.
Report one service for the fetal contraction stress test, supported by documentation that contractions and the fetal heart rate response were evaluated. CMS treats this as a diagnostic test: modifier 26 reports the professional interpretation, modifier TC reports the technical service, and no modifier reports the global service. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this single fetal test. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are not permitted.
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.
59020 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $76.32 | Unavailable |
How the 59020 rate is calculated
Each of 59020’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 · 59020
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.64Practice expense 1.35Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59020
The CMS indicators that decide how 59020 is paid alongside other services.
CMS payment indicators · 59020
Fetal stress test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
59020 without 26 · national office
$72.81
Fetal stress test
59020-26 · Professional component
$36.74
Pays only the interpretation and report.
59020 compared with similar codes
Compare codes
59020 vs 59025 vs 59050 vs 59051: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59025Fetal testing
- Choose 59020 when fetal heart rate response to uterine contractions is assessed; choose 59025 for a non-stress test without contraction stress.
- 59050Labor monitoring
- 59050 concerns fetal monitoring during labor with a written report. Code 59020 describes contraction stress testing for antepartum fetal assessment.
- 59051Fetal monitoring
- 59051 reports interpretation of fetal monitoring during labor. Code 59020 reports the contraction stress test, not labor-monitor interpretation alone.
59020 billing questions
How does this differ from 59025?
Code 59020 is for assessing the fetal heart rate response to uterine contractions. Code 59025 is a non-stress test, which monitors fetal heart rate without contraction stress.
Can the professional and technical services be billed separately?
Yes. Use modifier 26 for the professional interpretation or TC for the technical service. Billing without either modifier represents the global service.
What documentation supports reporting 59020?
Document the indication, the contraction activity evaluated, the fetal heart rate response, and the interpretation. The record should support that a contraction stress test was performed rather than a non-stress test.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this single fetal test.
What care is included in the global service?
The 0-day global period includes same-day preoperative and postoperative care. It does not create a multi-day global package.
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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