# CPT 99495

> The national PFS baseline was $201.20 for CPT 99495 in the Office (non-facility) setting and $134.24 in a facility under the Q4 2025 Physician Fee Schedule, effective October 2025. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded. Across payment localities, the office amount is $183.74–$253.78 and the facility amount is $126.15–$180.10. This amount has been unchanged since Q1 2025, when it decreased 2.7%.

## What it is

Transitional Care After Discharge

## Selected release

- Release: Q4 2025 (2025 D)
- Effective: October 1 – December 31, 2025
- Status indicator: A
- Office (non-facility) national allowed amount: $201.20
- Facility national allowed amount: $134.24
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.78
- Office (non-facility) practice expense RVU: 3.27
- Facility practice expense RVU: 1.20
- Malpractice RVU: 0.17
- Conversion factor: 32.3465
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2025)
- CMS file: https://www.cms.gov/files/zip/rvu25d-updated-09/11/2025.zip
- Parsed file: PPRRVU2025_Oct.csv, row 12,949
- Canonical page: https://localishealth.com/cpt/99495/2025/A
- Release-specific citation URL: https://localishealth.com/cpt/99495/2025/D
- Last significant update: 2026-08-13T15:11:57+00:00