CPT 99495

Chronic, Principal, and Transitional Care Management

Current code41 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for CPT 99495 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Cascade Medical CenterLeavenworth$296 – $4427 plans$423$529
EvergreenHealth Medical CenterKirkland$147 – $1505 plans$128 – $256$160 – $320
Harborview Medical CenterSeattleFile dated 2026-04-01—$240$343
Island HospitalAnacortes$159 – $16811 plansDoctor’s fee: $159 – $168$312Doctor’s fee: $312$312Doctor’s fee: $312
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$133 – $378Doctor’s fee: $246 – $378$204 – $582Doctor’s fee: $378 – $582
Mason General Hospital & Family of ClinicsShelton$222 – $4772 plans$238$318
University of Washington Medical CtrSeattleFile dated 2026-04-01—$228$326
Virginia Mason Medical CenterSeattle—$72.42$142
Yakima Valley MemorialYakimaFile dated 2026-08-27—$145$362

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County)
$251 in an office; $131 in a hospital or surgery center
Doctor's fee, rest of Washington
$226 in an office; $123 in a hospital or surgery center
Hospital outpatient payment (national)
$136 (APC 5012)

How hospitals also write this code

Some price files write it differently. These are counted as CPT 99495:

  • 99495P (with a letter after it, P; 4 price lines)
  • 99495T (with a letter after it, T; 2 price lines)