{
    "code": "99458",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99458/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/99458/2020/A",
    "description": "Extra time spent by a clinician or clinical staff managing a patient whose physiologic data is being tracked at home, billed on top of the first block of monthly management time. The work is the same as the base service - reviewing transmitted readings such as blood pressure, weight, or blood oxygen, contacting the patient about them, and adjusting treatment - but this code accounts for a further 20 minutes in the same calendar month. It exists so that a patient needing heavy, ongoing attention is not lumped in with one needing a quick monthly check of the data.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99458 in Q1 2020?",
        "text": "Medicare paid $42.22 for CPT 99458 in the office (non-facility) setting and $32.84 in a facility under the Q1 2020 Physician Fee Schedule, effective January 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "A",
        "label": "Q1 2020",
        "effective": "January 1 – March 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 42.22,
        "facility": 32.84,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.61,
        "practice_expense_non_facility": 0.51,
        "practice_expense_facility": 0.25,
        "malpractice": 0.05
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q1 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20a-updated-01312020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/A",
        "file": "PPRRVU20_Jan.csv",
        "row": 17192,
        "sha256": "28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d"
    },
    "modified_at": "2026-08-04T03:09:22+00:00"
}