99490
Chronic care management — first 20 minutes of clinical staff time
The base monthly CCM code for patients with two or more chronic conditions.
2026 national amount
$66.30
Billing cadence
Per calendar month
Code family
CCM
- Two or more chronic conditions expected to last at least 12 months, or until death
- The conditions place the patient at significant risk of decompensation, exacerbation, or death
- At least 20 minutes of clinical staff time directed by a physician or qualified health professional
- A comprehensive care plan is established, implemented, revised, and available to the care team
- Patient consent is obtained and documented
- Can be billed in the same month as RPM or RTM — the time must be separately documented
- Add 99439 for each further 20 minutes of clinical staff time
Who can bill it
Clinical staff time directed by a physician or qualified health professional.
Other CCM codes.
- 99439The add-on for each further 20 minutes of CCM clinical staff time
- 99491CCM delivered personally by the physician or QHP rather than by clinical staff
- 99437The add-on for each further 30 minutes of the physician's own CCM time
- 99487The complex-CCM base code, for patients needing moderate or high complexity decision-making
- 99489The add-on for each further 30 minutes of complex CCM clinical staff time
A code is a claim. Documentation is the proof.
Most denied monitoring claims fail on documented time, consent, or the interactive communication — not on choosing the wrong code. We build the workflow so the record is made as the care happens.
- 99445 (2–15 days) and 99454 (16–30 days) cannot be billed in the same 30-day period
- 98984/98976 and 98985/98977 follow the same rule
- 99470 (10 min) and 99457 (20 min) cannot be billed in the same month
- 98979 (10 min) and 98980 (20 min) follow the same rule
- Add-on codes (99458/98981) only pair with the 20-minute base codes
- RPM and RTM cannot be billed for the same patient in the same month
- All treatment management codes require at least one live interactive communication per month
- 99454 requires automatic data transmission from the device
- Minimum 2 days of data transmission for all device supply codes
Amounts shown are 2026 national figures and are an estimate, not a quote — actual payment varies by locality, payer, and documented time. This reference is a summary for planning, not billing advice or a substitute for the current fee schedule and payer policy.
Billing 99490 correctly is the whole job.
We run the CCM programme and the revenue cycle behind it — documented time, consent, and claims handled as part of the care rather than after it.