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99454 Rem mntr physiol param 16-30

What 99454 is

CMS fee schedule short descriptor: Rem mntr physiol param 16-30.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 99454 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.001.550.011.56$52.11
Facility (hospital, ASC)0.001.550.011.56$52.11

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

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Medically Unlikely Edit (MUE)

Medicare caps 99454 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 99454? These codes are bundled into it

99454 is a Column 1 code in 25 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0733TRem r-t mtn nrehab ther sply1 - modifier may bypassCheck pair
0811TRem mlt day uroflow setup0 - no modifier bypassCheck pair
0812TRem mlt day uroflow dev sply0 - no modifier bypassCheck pair
0937TXtrnl ecg rec>15d<30d0 - no modifier bypassCheck pair
0938TXtrnl ecg rec>15d<30d rec0 - no modifier bypassCheck pair
0939TXtrnl ecg rec>15d<30d scan0 - no modifier bypassCheck pair
0940TXtrnl ecg rec>15d<30d r&i0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
93241Xtrnl ecg rec>48hr<7d0 - no modifier bypassCheck pair
93242Ext ecg>48hr<7d recording0 - no modifier bypassCheck pair
93243Ext ecg>48hr<7d scan a/r0 - no modifier bypassCheck pair
93244Ext ecg>48hr<7d rev&interpj0 - no modifier bypassCheck pair
93245Ext ecg>7d<15d rec scan a/r0 - no modifier bypassCheck pair
93246Ext ecg>7d<15d recording0 - no modifier bypassCheck pair
93247Ext ecg>7d<15d scan a/r0 - no modifier bypassCheck pair
93248Ext ecg>7d<15d rev&interpj0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
98975Rtm 1st set-up&pt educaj eqp1 - modifier may bypassCheck pair
98976Rtm dev sply resp sys 16-30d1 - modifier may bypassCheck pair
98977Rtm dev sply mscskl 16-30 d1 - modifier may bypassCheck pair
99091Collj & interpj data ea 30 d0 - no modifier bypassCheck pair
99452Ntrprof ph1/ntrnet/ehr rfrl0 - no modifier bypassCheck pair
99473Self-meas bp pt educaj/train0 - no modifier bypassCheck pair
G0250Md inr test revie inter mgmt1 - modifier may bypassCheck pair

99454 is bundled into these codes

99454 appears as a Column 2 code in 81 active edits. Reported with one of these Column 1 codes on the same date of service, 99454 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0378TVisual field assmnt rev/rprt0Check pair
0379TVis field assmnt tech suppt0Check pair
0578TRem interrog dev icds phys0Check pair
0579TRem interrog dev icds tech0Check pair
0604TRem oct rta dev setup&educaj1Check pair
0605TRem oct rta techl sprt min 81Check pair
0606TRem oct rta phys/qhp ea 30d1Check pair
0734TRem r-t mtn nrehab tx mgmt0Check pair
0741TRem auton alg nsln data coll0Check pair
0928TRem interrog dev ccm-d phys1Check pair
0929TRem interrog dev ccm-d tech1Check pair
0934TRem mntr wrls l atr prs snr1Check pair
80503Path clin consltj sf 5-200Check pair
80504Path clin consltj mod 21-400Check pair
80505Path clin consltj high 41-600Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.