How much does Medicare pay for CPT 99458?

Medicare allowed an average of $39.11 per service and paid $30.61 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $88.28, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99458?

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes. It was billed 2,066,989 times to 291,927 Medicare beneficiaries by 4,522 providers in 2024.

Does 99458 pay differently in an office than a hospital?

Yes. The allowed amount averaged $39.19 in an office setting and $28.86 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 99458 most?

Internal Medicine, with 522,369 services from 1,188 clinicians. Next are Cardiology, Family Practice, Nephrology.

CPT 99458

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

$39.11Medicare-allowed amount per service, averaged across 2,066,989 services

Providers submitted

$88.28

Asking price, not received

Medicare allowed

$39.11

The fee schedule figure

Medicare paid

$30.61

Balance is patient coinsurance

Providers submitted an average of $88.28 for this code and Medicare allowed $39.11 — 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 $30.61 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $39.19
Hospital / facility: $28.86

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. 2,049,650 services were billed in an office setting and 17,339 in a facility.

Services: 2,066,989
Beneficiaries: 291,927
Providers billing it: 4,522
Total allowed: $80,839,940

What Medicare pays for CPT 99458

Across 2,066,989 services billed by 4,522 providers to 291,927 beneficiaries, Medicare allowed an average of $39.11 per service. That is 7.1 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 99458

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	522,369	72,389	$40.16	1,188
Cardiology	465,123	65,218	$39.60	678
Family Practice	349,925	48,885	$39.05	806
Nephrology	221,439	24,030	$38.54	451
Nurse Practitioner	113,514	21,477	$32.59	511
Emergency Medicine	64,382	10,317	$40.91	41
Pulmonary Disease	43,690	5,369	$39.29	130
Interventional Cardiology	43,528	8,696	$39.53	155
General Practice	27,656	3,325	$40.95	54
Endocrinology	27,090	3,512	$41.05	61
Anesthesiology	23,529	1,404	$38.68	22
Physician Assistant	22,376	3,721	$33.04	105
Physical Medicine and Rehabilitation	16,775	1,605	$37.85	17
Geriatric Medicine	15,892	5,851	$38.85	13
Radiation Oncology	15,275	4,113	$39.49	1

99458 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	451,295	$42.04	$30.07	691
Texas	259,033	$38.14	$29.89	515
Florida	257,080	$38.83	$30.16	335
New York	127,423	$41.80	$29.75	340
Georgia	118,278	$36.91	$29.31	252
Arizona	72,088	$36.98	$29.26	216
Illinois	69,293	$39.24	$30.05	150
Tennessee	54,481	$35.79	$29.52	107
New Jersey	53,525	$41.35	$29.92	227
Michigan	49,383	$38.69	$29.77	111
Virginia	48,640	$38.28	$30.05	181
Maryland	46,967	$41.04	$29.47	127
North Carolina	35,472	$36.56	$29.91	99
Connecticut	29,700	$39.63	$30.28	25
Ohio	27,488	$35.91	$29.23	67
Missouri	24,256	$36.34	$29.35	52
Massachusetts	22,214	$39.49	$29.37	55
Kansas	21,936	$36.18	$29.96	36
Oklahoma	21,468	$36.44	$29.95	45
Utah	21,041	$36.44	$29.24	36
Indiana	19,940	$36.08	$29.75	46
Louisiana	18,127	$36.12	$29.71	51
Washington	17,790	$38.50	$29.04	38
Oregon	17,691	$39.09	$30.29	19
South Carolina	17,297	$37.17	$29.37	95
Pennsylvania	17,158	$38.52	$30.05	72
Colorado	16,908	$39.48	$30.38	64
Alabama	16,153	$35.95	$29.79	73
Kentucky	15,146	$34.96	$29.00	23
Mississippi	12,796	$34.70	$28.50	47
Nevada	12,750	$36.92	$29.42	58
Arkansas	12,650	$35.69	$30.06	38
Delaware	10,568	$37.85	$28.97	21
Nebraska	10,540	$37.07	$30.10	25
Hawaii	6,139	$38.38	$28.44	16
Idaho	5,026	$33.39	$27.46	12
New Mexico	4,355	$36.18	$28.74	22
District of Columbia	3,315	$43.10	$29.97	18
Iowa	2,975	$35.72	$29.44	52
South Dakota	2,580	$36.17	$29.65	6
Wisconsin	2,485	$34.00	$27.48	8
New Hampshire	2,484	$34.83	$26.05	12
Montana	2,155	$38.64	$29.03	1
Minnesota	2,035	$36.73	$29.83	7
Maine	1,995	$38.08	$30.17	5
West Virginia	1,533	$36.02	$29.39	7
Alaska	1,396	$49.18	$28.87	11
Wyoming	951	$38.20	$30.15	4
U.S. Virgin Islands	852	$38.59	$29.69	2
North Dakota	91	$38.29	$30.77	1
Vermont	47	$37.89	$30.80	1

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
99457Management using the results of remote vital sign monitoring per calen$48.61
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.