CPT 99458

Definition

CPT 99458 is the Medicare billing code for each additional 20 minutes of interactive communication with an RPM patient beyond the first 20 minutes covered by CPT 99457, reimbursed at approximately $41 and billable up to twice per patient per calendar month. It is an add-on code that ONLY applies when CPT 99457 is also billed for the same patient in the same calendar month.

CPT 99458 can be billed twice, covering minutes 21\u201340 and 41\u201360, bringing total monthly interactive-communication revenue to roughly $134 per patient (99457 + 2\u00d799458). The 2026 Medicare national average reimbursement for CPT 99458 is \u007e$41 per 20-minute block. Rates are updated annually through the Medicare Physician Fee Schedule.

Regulatory basis

CPT 99458 is governed by CMS under the Medicare Physician Fee Schedule as an add-on to CPT 99457. Each 20-minute block billed under 99458 must meet the same real-time, two-way interactive communication criteria as 99457 \u2014 asynchronous data review does not count, and interactions must address physiologic data, symptoms, or the patient\u2019s care plan.

Because 99458 is capped at two units per patient per calendar month, providers cannot bill for more than 60 total cumulative interactive-communication minutes under the 99457 + 99458 code family in a single month. Annual updates are published in the Medicare Physician Fee Schedule final rule.

Who uses it and when it applies

• Same provider types as 99457 (physicians, NPPs, clinical staff, AI-powered systems with human escalation)
• Patients with active interactive-communication time exceeding the 99457 threshold of 20 cumulative minutes
• Billable up to TWICE per calendar month (minutes 21\u201340 and 41\u201360)
• Requires CPT 99457 to also be billed for the same patient in the same month

Related terms

• CPT 99457 \u2014 the base interactive-communication code that 99458 adds onto
• CPT 99454 \u2014 the device supply code billed monthly alongside 99457 and 99458
• Remote Patient Monitoring \u2014 the broader care model that CPT 99458 helps fully reimburse

How Positive Check relates

Positive Check\u2019s daily wellness calls naturally exceed 20 minutes cumulative per patient per month for engaged populations, unlocking 99458 billings and maximizing per-patient revenue without requiring additional clinical staff time. See the Remote Patient Monitoring solution or the CPT 99457 billing guide for time-tracking and documentation practices that support both 99457 and 99458 claims.