How much does Medicare pay for CPT 99457?

Medicare allowed an average of $48.61 per service and paid $37.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $113.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99457?

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes. It was billed 2,500,830 times to 490,135 Medicare beneficiaries by 6,982 providers in 2024.

Does 99457 pay differently in an office than a hospital?

Yes. The allowed amount averaged $48.99 in an office setting and $29.74 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99457 most?

Internal Medicine, with 629,128 services from 1,856 clinicians. Next are Cardiology, Family Practice, Nephrology.

CPT 99457

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes

$48.61Medicare-allowed amount per service, averaged across 2,500,830 services

Providers submitted

$113.58

Asking price, not received

Medicare allowed

$48.61

The fee schedule figure

Medicare paid

$37.51

Balance is patient coinsurance

Providers submitted an average of $113.58 for this code and Medicare allowed $48.61 — 2.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $37.51 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $48.99
Hospital / facility: $29.74

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,451,219 services were billed in an office setting and 49,611 in a facility.

Services: 2,500,830
Beneficiaries: 490,135
Providers billing it: 6,982
Total allowed: $121,565,346

What Medicare pays for CPT 99457

Across 2,500,830 services billed by 6,982 providers to 490,135 beneficiaries, Medicare allowed an average of $48.61 per service. That is 5.1 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99457

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	629,128	117,604	$49.94	1,856
Cardiology	606,393	103,291	$49.03	882
Family Practice	390,363	77,322	$48.47	1,429
Nephrology	189,237	30,720	$48.14	556
Nurse Practitioner	148,594	37,290	$41.14	855
Interventional Cardiology	91,005	16,736	$49.60	222
Geriatric Medicine	90,331	30,083	$49.21	20
Pulmonary Disease	55,824	10,229	$48.81	173
Emergency Medicine	51,486	13,584	$49.80	54
Endocrinology	32,633	6,436	$50.89	105
Clinical Cardiac Electrophysiology	30,889	5,437	$47.10	86
General Practice	27,268	5,147	$50.48	74
Physician Assistant	24,749	6,165	$41.58	175
Radiation Oncology	14,461	5,666	$49.33	1
Gastroenterology	11,941	2,232	$47.38	94

99457 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	514,251	$51.67	$36.01	921
Texas	261,123	$47.25	$36.88	741
Florida	245,145	$47.87	$36.92	512
New York	199,018	$51.72	$36.27	564
Georgia	118,454	$45.59	$36.29	347
Connecticut	108,958	$49.82	$37.85	41
New Jersey	103,618	$52.68	$36.99	383
Virginia	99,743	$48.47	$36.01	244
Arizona	89,459	$46.54	$36.19	313
Illinois	66,644	$49.06	$36.95	243
Tennessee	61,568	$44.27	$36.09	172
Maryland	58,818	$51.39	$35.91	173
Michigan	47,871	$48.26	$36.82	170
South Carolina	41,447	$45.27	$36.18	186
Missouri	38,385	$46.51	$36.97	60
North Carolina	34,896	$45.03	$36.29	164
Pennsylvania	31,129	$48.48	$36.31	124
Iowa	27,817	$43.41	$34.32	194
Nevada	26,764	$46.64	$36.45	102
Alabama	26,563	$43.92	$36.68	150
Louisiana	22,603	$44.29	$36.40	84
Indiana	20,916	$44.75	$36.23	86
Massachusetts	20,455	$49.31	$35.87	70
Oklahoma	20,024	$44.47	$36.38	81
Washington	18,747	$48.08	$34.88	72
Ohio	18,246	$43.63	$35.29	78
Kansas	17,070	$45.54	$36.88	42
Utah	15,777	$45.29	$35.73	51
Mississippi	15,440	$42.79	$35.45	80
Arkansas	15,436	$43.01	$36.15	90
Colorado	14,531	$49.13	$37.01	79
Delaware	14,217	$47.36	$35.16	24
Oregon	13,628	$48.30	$36.10	21
Kentucky	12,293	$43.50	$35.33	38
Nebraska	9,092	$44.98	$36.48	35
New Mexico	8,128	$45.09	$35.61	45
Hawaii	6,942	$49.92	$36.04	25
Idaho	6,155	$37.38	$30.30	18
District of Columbia	5,332	$53.16	$36.07	26
New Hampshire	4,250	$43.31	$32.62	20
Minnesota	3,444	$37.18	$28.86	27
Wisconsin	3,276	$42.57	$33.53	26
South Dakota	2,344	$44.76	$36.03	8
West Virginia	2,231	$45.89	$36.94	11
Montana	2,059	$48.06	$34.36	4
Alaska	2,007	$58.36	$35.17	15
Wyoming	1,469	$46.83	$35.19	8
Maine	1,280	$47.32	$37.41	5
Rhode Island	773	$51.17	$36.92	1
U.S. Virgin Islands	541	$47.86	$36.39	3
North Dakota	405	$33.35	$24.81	3
Vermont	48	$44.39	$35.43	2

Related codes

99490Chronic care management services$59.70
99439Chronic care management services for two or more chronic conditions$46.13
99497Advance care planning$73.95
99458Management using the results of remote vital sign monitoring per calen$39.11
99454Remote monitoring of physiologic parameters$47.97
99489Complex chronic care management services for two or more chronic condi$67.00
99442Telephone medical discussion$83.84
99443Telephone medical discussion$120.39
99487Complex chronic care management services for two or more chronic condi$124.70
99496Transitional care management services for problem of high complexity$252.87
99426Principal care management services for a single high-risk disease$60.08
99484Care management services for behavioral health conditions$50.05

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.