Digital, remote monitoring & care management

99491 - RVUs & Medicare payment (2026)

Chronic care management by physician/QHP, first 30 minutes/month.

Component	Non-facility	Facility
Work RVU	1.50	1.50
Practice expense RVU	1.08	0.37
Malpractice RVU	0.09	0.09
Total RVUs	2.67	1.96
National payment (CF $33.4009)	$89.18	$65.47
Qualifying APM payment (CF $33.5675)	$89.63	$65.79

How 99491 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99491 ranges from $82.64 in Arkansas (AR) to $115.23 in Alaska (AK); calculate 99491 for your locality.

Alaska (AK) $115.23 San Jose-Sunnyvale-Santa Clara (CA) $109.24 San Jose-Sunnyvale-Santa Clara (CA) $108.82 San Francisco-Oakland-Berkeley (CA) $107.10 San Francisco-Oakland-Berkeley (CA) $107.00 Napa (CA) $102.33 Vallejo (CA) $102.18 NYC Suburbs/Long Island (NY) $101.78 National average $89.18 … 97 more localities between … Rest Of Missouri (MO) $84.12 Mississippi (MS) $83.38 Alabama (AL) $83.37 Arkansas (AR) $82.64

Non-facility payment for 99491 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - digital, remote monitoring & care management

99421 · online digital e/m, 5-10 minutes over 7 days
99422 · online digital e/m, 11-20 minutes over 7 days
99423 · online digital e/m, 21+ minutes over 7 days
98966 · telephone assessment by qualified nonphysician, 5-10 minutes
98967 · telephone assessment by qualified nonphysician, 11-20 minutes
98968 · telephone assessment by qualified nonphysician, 21-30 minutes
99453 · remote physiologic monitoring, setup and patient education
99454 · remote physiologic monitoring, device supply per 30 days
99457 · remote physiologic monitoring management, first 20 minutes/month
99458 · remote physiologic monitoring management, each additional 20 minutes
98975 · remote therapeutic monitoring, setup and patient education
98977 · remote therapeutic monitoring, device supply per 30 days (musculoskeletal)
98980 · remote therapeutic monitoring management, first 20 minutes/month
98981 · remote therapeutic monitoring management, each additional 20 minutes
99490 · chronic care management, clinical staff, first 20 minutes/month
99439 · chronic care management, clinical staff, each additional 20 minutes
99495 · transitional care management, moderate complexity (14-day contact)
99496 · transitional care management, high complexity (7-day contact)
99484 · general behavioral health integration care management, per month

Frequently asked questions

How much does Medicare pay for 99491 in 2026?

The national non-facility payment is $89.18 and the facility payment is $65.47, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 99491?

The 2026 work RVU for 99491 is 1.50. Total RVUs are 2.67 in the non-facility setting and 1.96 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.