{
    "code": "99495",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99495/2015/A",
    "release_specific_url": "https://localishealth.com/cpt/99495/2015/A",
    "description": "A bundle of services that manages a patient’s move from a hospital, skilled-nursing facility, or similar setting back to the community over the 30 days after discharge, for a case of moderate complexity — for example, coordinating follow-up after a hip-fracture repair with a few manageable chronic conditions. It requires an interactive contact (phone, in-person, or telehealth) within 2 business days of discharge and a face-to-face office visit within 14 calendar days.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99495 in Q1 2015?",
        "text": "Medicare paid $165.54 for CPT 99495 in the office (non-facility) setting and $111.91 in a facility under the Q1 2015 Physician Fee Schedule, effective January 2015. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.9% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2015,
        "quarter": "A",
        "label": "Q1 2015",
        "effective": "January 1 – March 31, 2015",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 165.54,
        "facility": 111.91,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.11,
        "practice_expense_non_facility": 2.38,
        "practice_expense_facility": 0.88,
        "malpractice": 0.14
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.7547,
    "source": {
        "label": "Physician relative value file (Q1 2015)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2015/A",
        "file": "PPRRVU15_V1223c.csv",
        "row": 16071,
        "sha256": "d600c52a7d5f75737599c9a879cc0ffc8c85766bee82e9e2eadf49af364314d2"
    },
    "modified_at": "2026-08-04T03:05:39+00:00"
}