Q. If I provide more than 20 minutes of chronic care management (CCM) services to my Medicare patient, can I bill more than one unit or more than one line item of CPT 99490 in the service period to account for this time?
A. CPT code 99490 (noncomplex CCM) describes a minimum number of minutes of service; there is no maximum. Therefore, you may bill only one unit and one line item of CPT 99490 per calendar month. Note also that only one practitioner can bill CCM per service period and must report either complex or noncomplex CCM, not both.
The five codes you can use for CCM services are:
- CPT code 99490: at least 20 minutes of non-face-to-face clinical staff time directed by a physician or other qualified health care professional per calendar month for Medicare patients with multiple chronic conditions
- CPT code 99491: at least 30 minutes of non-face-to-face time, provided personally by a physician or other qualified health care professional per calendar month for Medicare patients with multiple chronic conditions
- CPT code 99487: complex CCM that requires establishment or substantial revision of a care plan, moderate or high complexity medical decisionmaking, and 60 minutes of clinical staff time
- CPT code 99489: an add-on code to complex CCM (CPT code 99487) for each additional 30 minutes of clinical staff time
- HCPCS code G0506: an add-on code to the CCM initiating visit that describes the work of the billing practitioner in a comprehensive assessment and care planning to patients outside of the usual effort described by the initiating visit code
The Centers for Medicare & Medicaid Services has items on its Health Care Professional Resources webpage to help you and your patients understand CCM services.
For more information about Medicare CCM, visit:
Want to be sure you’re coding CCM or other services correctly? Call on TMA Practice Consulting for a Coding and Documentation Review. Contact a consultant for more information at (800) 523-8776 or email practice.consulting[at]texmed[dot]org.
Published June 28, 2017
TMA Practice E-Tips main page
Last Updated On
November 22, 2019
Originally Published On
June 28, 2017