Chronic Care Management

Medicare covers chronic care management services if a patient has two or more serious conditions that are expected to last at least a year.

Medical offices often question the correct way to code for CCM for Medicare. CodingIntel provides the correct way to utilize CPT^® 99490, 99491, 99487, 99489 and 99439.

• CPT^® added a new CCM code in 2021, +99439. It may be used with code 99490 to report each additional 20 minutes of clinical staff time doing CCM. The definition of code 99490 was amended from “20 minutes” to “first 20 minutes.”

Use of CPT^® codes 99490, 99439, 99487, 99489, 99491 and HCPCS code G0506

99487 – Complex chronic care management services, with the following required elements:

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

+ 99489– 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)

99490– 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:

• Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient;
• Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline;
• Comprehensive care plan established, implemented, revised, or monitored.

Login to read the rest of this article

---

Don’t have a login? Become a member, or learn more about the benefits of membership by clicking on the link below.