99496
Care Mgmt / CounselCMS status: ATransitional care management, high complexity, face-to-face within 7 days of discharge.
Work RVU
3.79
Practice RVU
4.91
Malpractice RVU
0.24
Total RVU
8.94
2026 Medicare payment
$298.60
National GPCI = 1.000 · Conversion factor $33.4009 · Non-facility
Model this code
Drop 99496 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 with high-complexity MDM and face-to-face within 7 days.
Documentation checklist
- ✓All 99495 elements, plus face-to-face within 7 days.
- ✓High-complexity MDM documented.
Common pitfalls
- !Same as 99495 — phone-contact window and med rec are the most common reasons for denial.
Common ICD-10 pairings
I50.22I63.9J44.1
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.