Care Mgmt · CMS status A

99437

Chronic care mgmt physician 30 min

Chronic care management, each additional 30 minutes of physician or QHP personal time per calendar month. CMS 2026 wRVU 1.00, 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.

Work RVU
1.00
2026 Medicare pays
$49.10
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.00 + Practice 0.40 + Malpractice 0.07 = 1.47 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.

Pairs well with

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