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99495 Transj care management mod f2f 14d

Evaluation & Management

Also known as: transitional care management moderate, post-hospital visit

Transitional care management service for moderate-risk patient with face-to-face evaluation within 14 days of discharge from inpatient hospital setting.

In Plain Language

follow-up visit after hospital discharge

Clinical Context

Used when physician evaluates recently discharged patient to assess transition to home care, medication reconciliation, and preventive care continuity.

RVU Breakdown

Work RVU2.78
Total RVU2.78

Est. Medicare Payment

$92.85

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 2.78, this code ranks in the 82nd percentile among Evaluation & Management codes — 1.8x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Internal MedicineFamily Medicine

Frequently Asked Questions

What is CPT code 99495?

CPT 99495 (Transj care management mod f2f 14d) is a Evaluation & Management code. Transitional care management service for moderate-risk patient with face-to-face evaluation within 14 days of discharge from inpatient hospital setting.

Who uses CPT code 99495?

CPT 99495 is used by Internal Medicine, Family Medicine. Used when physician evaluates recently discharged patient to assess transition to home care, medication reconciliation, and preventive care continuity.

When is CPT 99495 used?

Used when physician evaluates recently discharged patient to assess transition to home care, medication reconciliation, and preventive care continuity.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.