Price Checker / CPT 99496
CPT 99496 — Transj care mgmt high f2f 7d
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$166
What Medicare pays in a hospital/ASC setting
$299
What Medicare pays in a physician's office
$1,133
Based on 9 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 99496
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| UPMC Western Psychiatric , PA | $2,716 | $2,173 | 810% |
| UPMC Western Psychiatric Pittsburgh, PA | $2,716 | — | 673% |
| Hoke Hospital , NC | $59 | — | 277% |
| Riceland Clinic Vidor Beaumont, TX | $861 | — | 136% |
| Riceland Medical Center RHC Winnie, TX | $861 | — | 136% |
| Riceland Nederland Clinic Nederland, TX | $861 | — | 136% |
| Riceland Regents Park Clinic Beaumont, TX | $861 | — | 136% |
| Pine Rest Christian Mental Health Services , MI | $432 | $346 | 45% |
| Aspire Health Partners, Inc Orlando, FL | $830 | — | 43% |
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About CPT 99496
CPT code 99496 refers to “Transj care mgmt high f2f 7d”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $166 in a facility (hospital or ambulatory surgery center) and $299in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.