Medicare Chronic Care Management (CCM) A Complete Guide

Medicare provides separate reimbursement for CCM services, allowing providers to bill for non-face-to-face care coordination. These services fall into two main categories:

Complex CCM and non-complex CCM are based on the severity of a patient’s condition and the level of care required.

Non-Complex CCM CPT Codes

• CPT Code 99490 – This covers at least 20 minutes per month of non-face-to-face care for patients with two or more chronic conditions. Medicare reimburses approximately $62 per patient per month.
• CPT Code 99439 – Each additional 20 minutes of non-complex CCM time, billed alongside 99490.
• CPT Code 99491 – Physician or qualified healthcare professional personally provides at least 30 minutes of monthly CCM services.

Complex CCM CPT Codes

• CPT Code 99487 – This covers 60 minutes of non-face-to-face care for patients requiring comprehensive care coordination due to multiple chronic conditions. Medicare reimburses around $133 per month.
• CPT Code 99489 – Each additional 30 minutes beyond the initial 60-minute requirement under 99487, reimbursed at approximately $76.50.