99496 Transj care management high f2f 7d
Also known as: transitional care management high-risk, urgent post-hospital visit
Transitional care management service for high-risk patient with face-to-face evaluation within 7 days of discharge from inpatient hospital setting.
In Plain Language
urgent follow-up visit shortly after hospital discharge
Clinical Context
Used for complex or high-risk patients requiring expedited post-discharge evaluation, including medication reconciliation and care plan adjustment.
RVU Breakdown
| Work RVU | 3.79 |
| Total RVU | 3.79 |
Est. Medicare Payment
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 3.79, this code ranks in the 90th percentile among Evaluation & Management codes — 2.5x the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99496?
CPT 99496 (Transj care management high f2f 7d) is a Evaluation & Management code. Transitional care management service for high-risk patient with face-to-face evaluation within 7 days of discharge from inpatient hospital setting.
Who uses CPT code 99496?
CPT 99496 is used by Internal Medicine, Family Medicine, Critical Care. Used for complex or high-risk patients requiring expedited post-discharge evaluation, including medication reconciliation and care plan adjustment.
When is CPT 99496 used?
Used for complex or high-risk patients requiring expedited post-discharge evaluation, including medication reconciliation and care plan adjustment.
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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.