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CMS October 2026Physician Fee Schedule · Free lookup

CPT 99458 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 99458 is $41.42 in a non-facility setting ($26.39 in a facility), up 7.6% from $38.49 in 2025.

National rate, October 2026
Non-facility
$41.42
Facility
$26.39
vs. 2025
+7.6%
Commercial national avg.
$54.00

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99458
20262025

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Up to 5 codes · 4 remaining

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Physician Fee Schedule·99458·National·2026, 2025
Current non-facility rate
$41.42▲0.0%
Facility: $26.39
Recent trend
Code description

Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)

CodeDateStateLocalityCarrierNon-Facility FeeFacility FeeDescription
9945810/2026N/A0000000$41.42$26.39Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994587/2026N/A0000000$41.42$26.39Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994584/2026N/A0000000$41.42$26.39Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994581/2026N/A0000000$41.42$26.39Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
9945810/2025N/A0000000$38.49$28.79Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994587/2025N/A0000000$38.49$28.79Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994584/2025N/A0000000$38.49$28.79Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)
994581/2025N/A0000000$38.49$28.79Rpm Tx Mgmt Ea Addl 20 Min, Remote Physiologic Monitoring Treatment Management Services Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring 1 Real-Time Interactive Communication With The Patient/Caregiver During The Calendar Month; Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure)

99458 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS fileNon-facilityFacilityChange
October 2026$41.42$26.39+7.6%
October 2025$38.49$28.79-2.0%
March 2024$39.28$29.63-0.9%
January 2023$39.65$30.16-2.9%
July 2022$40.84$31.15-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

99458: Medicare vs. commercial national average

The commercial national average for 99458, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $54.00, 130% of Medicare's $41.42.

  • BCBS $48.77
  • UnitedHealthcare $51.83
  • Aetna $45.74
  • Cigna $69.66

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 99458 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

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Medicaid comparison

See what state Medicaid programs pay for 99458

50 state Medicaid agencies publish their own physician fee schedule. The 99458 page shows real published rates for several of them free, with effective dates and official sources.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.