CPT 99496

Chronic, Principal, and Transitional Care Management

Current code42 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

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 99496 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Medical CenterLeavenworth	$422 – $6354 plans	$607	$759
EvergreenHealth Medical CenterKirkland	—	$160 – $320	$200 – $400
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$315	$451
Island HospitalAnacortes	$73.05 – $79.253 plansDoctor’s fee: $73.05 – $79.25	$453Doctor’s fee: $453	$453Doctor’s fee: $453
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$179 – $512Doctor’s fee: $333 – $512	$276 – $788Doctor’s fee: $512 – $788
Mason General Hospital & Family of ClinicsShelton	—	$317	$422
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$302	$431
Virginia Mason Medical CenterSeattle	—	$77.01	$151
Yakima Valley MemorialYakimaFile dated 2026-08-27	—	$146	$366

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): $341 in an office; $178 in a hospital or surgery center
Doctor's fee, rest of Washington: $307 in an office; $168 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 99496:

99496P (with a letter after it, P; 4 price lines)
99496T (with a letter after it, T; 2 price lines)