CPT codes for Chronic Care Management

 

  • CPT 99490- (Standard CCM) $42

Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:

  1. Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  2. Chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline
  3. Comprehensive care plan established, implemented, revised, or monitored
  • CPT 99491- (Physician Provided CCM)- $84

30+ minutes of care management outside of office visits and Provided personally by a physician or other qualified healthcare professional

  • HCPCS G2058–Non Complex Add-on (new 2020)- $37x 2  

Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (limit 2x during service period)

  • CPT 99487- (Complex CCM)- $94

Complex chronic care management services, with the following, required elements:

  1. Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  2. Chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline
  3. Establishment or substantial revision of a comprehensive care plan
  4. Moderate or high complexity medical decision making
  5. 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month
  • CPT 99489- Complex CCM (Add-on)- $47

Each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

  • HCPCSG0506- (Comprehensive Assessment & Care Planning)- $63  

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to code for primary procedure)