99495
Care Mgmt / CounselCMS status: ATransitional care management, moderate complexity, face-to-face within 14 days of discharge.
Work RVU
2.78
Practice RVU
3.62
Malpractice RVU
0.19
Total RVU
6.59
2026 Medicare payment
$220.11
National GPCI = 1.000 · Conversion factor $33.4009 · Non-facility
Model this code
Drop 99495 into a scenario to see how unit volume rolls up to annual wRVUs, gross collections, and bonus.
Open in calculator →When to use it
Post-discharge transition. Phone contact within 2 business days, face-to-face visit within 14 days.
Documentation checklist
- ✓Date and time of post-discharge phone contact (interactive, within 2 business days).
- ✓Date of face-to-face within 14 days.
- ✓Medication reconciliation before or at the face-to-face.
- ✓MDM at least moderate complexity.
Common pitfalls
- !Missing the 2-business-day contact window.
- !Failing to reconcile meds — automatic denial.
- !Billing during the same month as CCM (99490).
Common ICD-10 pairings
Z48.01I50.21
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.