Care Mgmt · CMS status A

99437

Chrnc care mgmt phys ea addl

Chronic care management, each additional 30 minutes of physician or QHP personal time per calendar month. paid using the national GPCI and the 2026 conversion factor of $33.4009. Add-on to 99491; it can never be billed alone or with the staff-time codes.

Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.

Work RVU
1.00
National non-QP estimate
$63.13
National GPCI · non-facility · CF $33.4009

Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.

RVU anatomyWork 1.00 + Practice 0.82 + Malpractice 0.07 = 1.89 total
Work (your effort)Practice expenseMalpractice
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Common ICD-10 pairings
E11.9I10N18.3I50.32J44.9G30.9

Payer notes

Medicare and Medicare Advantage cover 99437 with standard cost share; disclose it in the annual CCM consent. Commercial coverage is limited, as with the rest of the CCM family. At wRVU 1.00 per 30-minute unit, a fully documented 90-minute clinician-personal month (99491 + 2 x 99437) carries 3.45 wRVU, more than a level 5 established visit (2.80), which is the economic argument for logging personal care management time instead of absorbing it.

Related codes

These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.

See what 99437 adds to your year

Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.