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CPT 99496 — Transj care mgmt high f2f 7d

CPT code 99496 (Transj care mgmt high f2f 7d) carries 3.79 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 8.94 in a non-facility setting and 4.98 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $298.60 and $166.34 respectively.

3.79
Work RVU
8.94
Total RVU (non-facility)
$298.60
Medicare, non-facility
$166.34
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 99496

ComponentRVUsWhat it covers
Work RVU3.79Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)4.91Office overhead, staff, supplies.
Practice expense RVU (facility)0.95Overhead when performed in a hospital.
Malpractice RVU0.24Professional liability cost.
Total RVU (non-facility)8.94Work + non-facility PE + malpractice.
Total RVU (facility)4.98Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 99496 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility8.94$33.40$298.60
Facility4.98$33.40$166.34

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 99496

Global period
Global concept does not apply to this code.
Multiple procedure reduction
No multiple-procedure payment reduction applies.
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted unless documentation supports medical necessity.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

99406 · 0.24 wRVU99407 · 0.5 wRVU99421 · 0.25 wRVU99422 · 0.5 wRVU99423 · 0.8 wRVU99424 · 1.45 wRVU99425 · 1.0 wRVU99426 · 1.0 wRVU

Questions about CPT 99496

How many work RVUs is CPT 99496?

CPT 99496 is assigned 3.79 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 99496?

At the 2026 national conversion factor of $33.40, CPT 99496 pays approximately $298.60 in a non-facility setting and $166.34 in a facility setting before geographic adjustment.

What is the global period for CPT 99496?

Global concept does not apply to this code.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.