{
    "code": "99457",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99457/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/99457/2021/B",
    "description": "The clinical work of actually using home monitoring data: reviewing the readings a patient's connected device has sent in, spotting trends, and changing treatment in response. It covers the first block of about twenty minutes of that management time in a calendar month, by a clinician or by staff working under them, and the month has to include at least one live back-and-forth conversation with the patient or their caregiver — a phone or video call, not just a message. Additional time beyond the first block is reported with a separate add-on.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99457 in Q2 2021?",
        "text": "Medicare paid $50.94 for CPT 99457 in the office (non-facility) setting and $31.75 in a facility under the Q2 2021 Physician Fee Schedule, effective April 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it decreased 1.3%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "B",
        "label": "Q2 2021",
        "effective": "April 1 – June 30, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 50.94,
        "facility": 31.75,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.61,
        "practice_expense_non_facility": 0.81,
        "practice_expense_facility": 0.26,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q2 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21b-updated-03022021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/B",
        "file": "PPRRVU21_APR.csv",
        "row": 17293,
        "sha256": "524bee7096166c9011a4ea02189783ef8c91f4d444585e5b2d561b879f9262de"
    },
    "modified_at": "2026-08-04T03:10:33+00:00"
}