# CPT 99495

> 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.

## What it is

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.

## Selected release

- Release: Q1 2015 (2015 A)
- Effective: January 1 – March 31, 2015
- Status indicator: A
- Office (non-facility) national allowed amount: $165.54
- Facility national allowed amount: $111.91
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.11
- Office (non-facility) practice expense RVU: 2.38
- Facility practice expense RVU: 0.88
- Malpractice RVU: 0.14
- Conversion factor: 35.7547
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2015)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15a.zip
- Parsed file: PPRRVU15_V1223c.csv, row 16,071
- Canonical page: https://localishealth.com/cpt/99495/2015/A
- Release-specific citation URL: https://localishealth.com/cpt/99495/2015/A
- Last significant update: 2026-08-04T03:05:39+00:00