# CPT 99495

> Medicare paid $207.96 for CPT 99495 in the office (non-facility) setting and $145.16 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 increased 10.8%.

## 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: Q2 2021 (2021 B)
- Effective: April 1 – June 30, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $207.96
- Facility national allowed amount: $145.16
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.78
- Office (non-facility) practice expense RVU: 3.01
- Facility practice expense RVU: 1.21
- Malpractice RVU: 0.17
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q2 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21b-updated-03022021.zip
- Parsed file: PPRRVU21_APR.csv, row 17,326
- Canonical page: https://localishealth.com/cpt/99495/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/99495/2021/B
- Last significant update: 2026-08-04T03:10:33+00:00