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 RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.00 | 1.55 | 0.01 | 1.56 | $52.11 |
| Facility (hospital, ASC) | 0.00 | 1.55 | 0.01 | 1.56 | $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.
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 code | Short description | Modifier indicator | |
|---|---|---|---|
0733T | Rem r-t mtn nrehab ther sply | 1 - modifier may bypass | Check pair |
0811T | Rem mlt day uroflow setup | 0 - no modifier bypass | Check pair |
0812T | Rem mlt day uroflow dev sply | 0 - no modifier bypass | Check pair |
0937T | Xtrnl ecg rec>15d<30d | 0 - no modifier bypass | Check pair |
0938T | Xtrnl ecg rec>15d<30d rec | 0 - no modifier bypass | Check pair |
0939T | Xtrnl ecg rec>15d<30d scan | 0 - no modifier bypass | Check pair |
0940T | Xtrnl ecg rec>15d<30d r&i | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
93241 | Xtrnl ecg rec>48hr<7d | 0 - no modifier bypass | Check pair |
93242 | Ext ecg>48hr<7d recording | 0 - no modifier bypass | Check pair |
93243 | Ext ecg>48hr<7d scan a/r | 0 - no modifier bypass | Check pair |
93244 | Ext ecg>48hr<7d rev&interpj | 0 - no modifier bypass | Check pair |
93245 | Ext ecg>7d<15d rec scan a/r | 0 - no modifier bypass | Check pair |
93246 | Ext ecg>7d<15d recording | 0 - no modifier bypass | Check pair |
93247 | Ext ecg>7d<15d scan a/r | 0 - no modifier bypass | Check pair |
93248 | Ext ecg>7d<15d rev&interpj | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
98975 | Rtm 1st set-up&pt educaj eqp | 1 - modifier may bypass | Check pair |
98976 | Rtm dev sply resp sys 16-30d | 1 - modifier may bypass | Check pair |
98977 | Rtm dev sply mscskl 16-30 d | 1 - modifier may bypass | Check pair |
99091 | Collj & interpj data ea 30 d | 0 - no modifier bypass | Check pair |
99452 | Ntrprof ph1/ntrnet/ehr rfrl | 0 - no modifier bypass | Check pair |
99473 | Self-meas bp pt educaj/train | 0 - no modifier bypass | Check pair |
G0250 | Md inr test revie inter mgmt | 1 - modifier may bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0378T | Visual field assmnt rev/rprt | 0 | Check pair |
0379T | Vis field assmnt tech suppt | 0 | Check pair |
0578T | Rem interrog dev icds phys | 0 | Check pair |
0579T | Rem interrog dev icds tech | 0 | Check pair |
0604T | Rem oct rta dev setup&educaj | 1 | Check pair |
0605T | Rem oct rta techl sprt min 8 | 1 | Check pair |
0606T | Rem oct rta phys/qhp ea 30d | 1 | Check pair |
0734T | Rem r-t mtn nrehab tx mgmt | 0 | Check pair |
0741T | Rem auton alg nsln data coll | 0 | Check pair |
0928T | Rem interrog dev ccm-d phys | 1 | Check pair |
0929T | Rem interrog dev ccm-d tech | 1 | Check pair |
0934T | Rem mntr wrls l atr prs snr | 1 | Check pair |
80503 | Path clin consltj sf 5-20 | 0 | Check pair |
80504 | Path clin consltj mod 21-40 | 0 | Check pair |
80505 | Path clin consltj high 41-60 | 0 | Check 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.