99495 Transj care mgmt mod f2f 14d
What 99495 is
CMS fee schedule short descriptor: Transj care mgmt mod f2f 14d.
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 99495 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.78 | 3.62 | 0.19 | 6.59 | $220.11 |
| Facility (hospital, ASC) | 2.78 | 0.69 | 0.19 | 3.66 | $122.25 |
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 99495 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 99495? These codes are bundled into it
99495 is a Column 1 code in 85 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 | |
|---|---|---|---|
0362T | Bhv id suprt assmt ea 15 min | 1 - modifier may bypass | Check pair |
0373T | Adapt bhv tx ea 15 min | 1 - modifier may bypass | Check pair |
0469T | Rta polarize scan oc scr bi | 0 - no modifier bypass | Check pair |
0488T | Diabetes prev online/elec | 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 |
94002 | Vent mgmt inpat init day | 0 - no modifier bypass | Check pair |
94003 | Vent mgmt inpat subq day | 0 - no modifier bypass | Check pair |
94004 | Vent mgmt nf per day | 0 - no modifier bypass | Check pair |
94660 | Cpap initiation&mgmt | 0 - no modifier bypass | Check pair |
96041 | Genetic counseling svc ea 30 | 1 - modifier may bypass | Check pair |
96127 | Brief emotional/behav assmt | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97151 | Bhv id assmt by phys/qhp | 1 - modifier may bypass | Check pair |
97153 | Adaptive behavior tx by tech | 1 - modifier may bypass | Check pair |
97154 | Grp adapt bhv tx by tech | 1 - modifier may bypass | Check pair |
97155 | Adapt behavior tx phys/qhp | 1 - modifier may bypass | Check pair |
97156 | Fam adapt bhv tx gdn phy/qhp | 1 - modifier may bypass | Check pair |
97157 | Mult fam adapt bhv tx gdn | 1 - modifier may bypass | Check pair |
97158 | Grp adapt bhv tx by phy/qhp | 1 - modifier may bypass | Check pair |
98000 | Synch audio-video new sf 15 | 1 - modifier may bypass | Check pair |
98001 | Synch audio-video new low 30 | 1 - modifier may bypass | Check pair |
98002 | Synch audio-video new mod 45 | 1 - modifier may bypass | Check pair |
98003 | Synch audio-video new hi 60 | 1 - modifier may bypass | Check pair |
98004 | Synch audio-video est sf 10 | 1 - modifier may bypass | Check pair |
98005 | Synch audio-video est low 20 | 1 - modifier may bypass | Check pair |
98006 | Synch audio-video est mod 30 | 1 - modifier may bypass | Check pair |
98007 | Synch audio-video est hi 40 | 1 - modifier may bypass | Check pair |
98008 | Synch audio-only new sf 15 | 1 - modifier may bypass | Check pair |
98009 | Synch audio-only new low 30 | 1 - modifier may bypass | Check pair |
Showing 30 of 85 column 2 codes. Use the pair checker for any specific combination.
99495 is bundled into these codes
99495 appears as a Column 2 code in 5574 active edits. Reported with one of these Column 1 codes on the same date of service, 99495 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0347T | Ins bone device for rsa | 1 | Check pair |
0395T | Hdr elctr ntrst/ntrcv brchtx | 0 | Check pair |
0397T | Ercp w/optical endomicroscpy | 1 | Check pair |
0402T | Colgn crs-link crn&pachymtry | 0 | Check pair |
0408T | Insj/rplc cardiac modulj sys | 0 | Check pair |
0409T | Insj/rplc car modulj pls gn | 0 | Check pair |
0410T | Insj/rplc car modulj atr elt | 0 | Check pair |
0411T | Insj/rplc car modulj vnt elt | 0 | Check pair |
0412T | Rmvl cardiac modulj pls gen | 0 | Check pair |
0413T | Rmvl car modulj tranvns elt | 0 | Check pair |
0414T | Rmvl & rpl car modulj pls gn | 0 | Check pair |
0415T | Repos car modulj tranvns elt | 0 | Check pair |
0416T | Reloc skin pocket pls gen | 0 | Check pair |
0419T | Dstrj neurofibroma xtnsv | 0 | Check pair |
0420T | Dstrj neurofibroma xtnsv | 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.