{
    "code": "99457",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99457/2023/A",
    "release_specific_url": "https://localishealth.com/cpt/99457/2023/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 2023?",
        "text": "Medicare paid $48.80 for CPT 99457 in the office (non-facility) setting and $30.16 in a facility under the Q2 2023 Physician Fee Schedule, effective April 2023. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2023, when it decreased 2.8%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2023,
        "quarter": "B",
        "label": "Q2 2023",
        "effective": "April 1 – June 30, 2023",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 48.8,
        "facility": 30.16,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.61,
        "practice_expense_non_facility": 0.79,
        "practice_expense_facility": 0.24,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 33.8872,
    "source": {
        "label": "Physician relative value file (Q2 2023)",
        "cms_url": "https://www.cms.gov/files/zip/rvu23b-updated-02/27/2023.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2023/B",
        "file": "PPRRVU23_APR.csv",
        "row": 17992,
        "sha256": "6a47fe38620fee5aff0fbba61f50983de3a9733e23acc7373c453261da6f0cd7"
    },
    "modified_at": "2026-08-04T03:12:43+00:00"
}